Medicare Part D coverage · doxepin hydrochloride · RxCUI 1000091

doxepin hydrochloride 50 MG/ML Topical Cream

Per the CMS 2026 Part D formulary file, doxepin hydrochloride 50 MG/ML Topical Cream is covered by 752 Medicare Part D plans (14.9% of enrollable products), averaging Tier 2.7, with prior authorization required on 69.2% of covering formularies.

14.9%
Plan coverage
752
Plans covering
T2.7
Avg tier
69.2%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for doxepin hydrochloride 50 MG/ML Topical Cream

Per the CMS 2026 Part D formulary file, doxepin hydrochloride 50 MG/ML Topical Cream (RxNorm concept RXCUI 1000091, generic name doxepin hydrochloride) appears on 39 distinct formulary files spanning 752 Medicare Part D plan offerings - 14.9% 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 2.7.

Real-world access to doxepin hydrochloride 50 MG/ML Topical Cream depends on utilization management as much as tier placement: 69.2% of covering formularies require prior authorization. 0% require step therapy. 79.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 276,316 Part D beneficiaries filled doxepin hydrochloride 50 MG/ML Topical Cream in 2023, with total plan-and-beneficiary spending of $78,711,446 and an average per-beneficiary annual cost of $284.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxepin hydrochloride 50 MG/ML Topical Cream today.

Coverage Details

Formularies covering
39
Plans covering
752
Coverage rate
14.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
69.2% of formularies
Step therapy required
0% of formularies
Quantity limits
79.5% of formularies

2023 Medicare Spending

Beneficiaries
276,316
Total spending
$78,711,446
Avg per beneficiary
$284.86

Tier Distribution Across Plans

15 plans
Tier 1, Preferred Generic
28 plans
Tier 2, Generic
57 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering doxepin hydrochloride 50 MG/ML Topical Cream

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

Plan Insurer Tier PA Premium States
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $0 NY
MetroPlus Advantage Plan (HMO D-SNP) Metroplus Health Plan, Inc. T1 Yes $0 NY
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 Yes $0 NY
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 Yes $0 NY
SeniorCare Complete (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
AbilityCare (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) Alameda Alliance FOR Health T1 Yes $0 CA
Community Care's Partnership Program (HMO D-SNP) Community Care Health Plan, Inc. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 Yes $0 CA
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
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $22.70 NY
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 Yes $34.50 NY
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) Elderplan, Inc. T1 Yes $44.80 NY
MetroPlus Platinum Plan (HMO) Metroplus Health Plan, Inc. T1 Yes $58.80 NY
Troy Medicare (HMO) Troy Health, Inc. T2 Yes $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Troy Health, Inc. T2 Yes $0 NC
Contra Costa Health Care Plus (HMO D-SNP) Contra Costa County Medical Service DBA Contra Costa Health T2 Yes $0 CA
Keystone First VIP Choice (HMO D-SNP) Vista Health Plan, Inc. T2 Yes $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) Vista Health Plan, Inc. T2 Yes $0 PA
Show the next 30 plans
First Choice VIP Care (HMO D-SNP) Select Health OF South Carolina, Inc. T2 Yes $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 Yes $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 Yes $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Caritas Florida, Inc. T2 Yes $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Caritas Louisiana, Inc. T2 Yes $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Caritas North Carolina, Inc. T2 Yes $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Michigan, Inc. T2 Yes $0 MI
MMM Supremo (HMO C-SNP) MMM Healthcare, LLC T2 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
MMM Unico (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Elite (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Deluxe (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
PMC Max (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Plenitud (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Valioso (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
MMM Grandioso (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Mega Flex (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
MMM Relax Platino (HMO D-SNP) MMM Healthcare, LLC T2 No $0 PR
MMM Balance (HMO-POS) MMM Healthcare, LLC T2 No $0 PR
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T4 Yes $0 CA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is doxepin hydrochloride 50 MG/ML Topical Cream covered by Medicare Part D?

Yes, doxepin hydrochloride 50 MG/ML Topical Cream is covered by 752 Medicare Part D plans (14.9% of all Part D formularies).

What tier is doxepin hydrochloride 50 MG/ML Topical Cream on Medicare Part D plans?

doxepin hydrochloride 50 MG/ML Topical Cream averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.

Does doxepin hydrochloride 50 MG/ML Topical Cream require prior authorization?

69.2% of Part D formularies require prior authorization for doxepin hydrochloride 50 MG/ML Topical Cream. Step therapy: 0%. Quantity limits: 79.5%.

How much does Medicare spend on doxepin hydrochloride 50 MG/ML Topical Cream?

In 2023, total Medicare Part D spending on doxepin hydrochloride 50 MG/ML Topical Cream was $78,711,446, covering 276,316 beneficiaries. The average spend per beneficiary was $284.86.

Nationwide similar Part D drugs

Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.

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