doxepin 3 MG Oral Tablet

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doxepin

RxCUI: 966787

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
48.3%
Plan Coverage
2,446
Plans Covering
T2.3
Avg Tier
1.6%
Prior Auth Required

What the CMS Formulary Data Shows for doxepin 3 MG Oral Tablet

Per the CMS 2026 Part D formulary file, doxepin 3 MG Oral Tablet (RxNorm concept RXCUI 966787, generic name doxepin) appears on 186 distinct formulary files spanning 2,446 Medicare Part D plan offerings - 48.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.

Real-world access to doxepin 3 MG Oral Tablet depends on utilization management as much as tier placement: 1.6% of covering formularies require prior authorization. 0.5% require step therapy. 96.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 276,316 Part D beneficiaries filled doxepin 3 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $78,817,401 and an average per-beneficiary annual cost of $285.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxepin 3 MG Oral Tablet today.

Coverage Details

Formularies covering
186
Plans covering
2,446
Coverage rate
48.3%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
1.6% of formularies
Step therapy required
0.5% of formularies
Quantity limits
96.2% of formularies

2023 Medicare Spending

Beneficiaries
276,316
Total spending
$78,817,401
Avg per beneficiary
$285.24

Tier Distribution Across Plans

82 plans
Tier 1, Preferred Generic
18 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering doxepin 3 MG Oral Tablet

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 No $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 No $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $0 NY
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T1 No $0 OR
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL

Frequently Asked Questions

Is doxepin 3 MG Oral Tablet covered by Medicare Part D?

Yes, doxepin 3 MG Oral Tablet is covered by 2,446 Medicare Part D plans (48.3% of all Part D formularies).

What tier is doxepin 3 MG Oral Tablet on Medicare Part D plans?

doxepin 3 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does doxepin 3 MG Oral Tablet require prior authorization?

1.6% of Part D formularies require prior authorization for doxepin 3 MG Oral Tablet. Step therapy: 0.5%. Quantity limits: 96.2%.

How much does Medicare spend on doxepin 3 MG Oral Tablet?

In 2023, total Medicare Part D spending on doxepin 3 MG Oral Tablet was $78,817,401, covering 276,316 beneficiaries. The average spend per beneficiary was $285.24.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial