doxycycline anhydrous 40 MG Delayed Release Oral Capsule
doxycycline anhydrous
RxCUI: 901399
What the CMS Formulary Data Shows for doxycycline anhydrous 40 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, doxycycline anhydrous 40 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 901399, generic name doxycycline anhydrous) appears on 16 distinct formulary files spanning 868 Medicare Part D plan offerings - 17.1% 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 3.3.
Real-world access to doxycycline anhydrous 40 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 31.3% of covering formularies require prior authorization. 0% require step therapy. 31.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,121,486 Part D beneficiaries filled doxycycline anhydrous 40 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $117,340,524 and an average per-beneficiary annual cost of $28.47. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxycycline anhydrous 40 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 16
- Plans covering
- 868
- Coverage rate
- 17.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 31.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 31.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,121,486
- Total spending
- $117,340,524
- Avg per beneficiary
- $28.47
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering doxycycline anhydrous 40 MG Delayed Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T2 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T2 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T2 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T2 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T2 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | 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 |
| 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 |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T4 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T4 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T4 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO) | AETNA HEALTH INC.(GA) | T4 | Yes | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T4 | Yes | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T4 | Yes | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T4 | Yes | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T4 | Yes | $0 | IL |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | IA |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | NE |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | AR |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
| Aetna Medicare Advantra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | OH |
Frequently Asked Questions
Is doxycycline anhydrous 40 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, doxycycline anhydrous 40 MG Delayed Release Oral Capsule is covered by 868 Medicare Part D plans (17.1% of all Part D formularies).
What tier is doxycycline anhydrous 40 MG Delayed Release Oral Capsule on Medicare Part D plans?
doxycycline anhydrous 40 MG Delayed Release Oral Capsule averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does doxycycline anhydrous 40 MG Delayed Release Oral Capsule require prior authorization?
31.3% of Part D formularies require prior authorization for doxycycline anhydrous 40 MG Delayed Release Oral Capsule. Step therapy: 0%. Quantity limits: 31.3%.
How much does Medicare spend on doxycycline anhydrous 40 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on doxycycline anhydrous 40 MG Delayed Release Oral Capsule was $117,340,524, covering 4,121,486 beneficiaries. The average spend per beneficiary was $28.47.
Read our methodology - how this data is sourced, computed, and verified.