doxycycline hyclate 50 MG Oral Tablet
doxycycline hyclate
RxCUI: 1652674
What the CMS Formulary Data Shows for doxycycline hyclate 50 MG Oral Tablet
Per the CMS 2026 Part D formulary file, doxycycline hyclate 50 MG Oral Tablet (RxNorm concept RXCUI 1652674, generic name doxycycline hyclate) appears on 20 distinct formulary files spanning 87 Medicare Part D plan offerings - 1.7% 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 1.7.
Real-world access to doxycycline hyclate 50 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,121,486 Part D beneficiaries filled doxycycline hyclate 50 MG Oral Tablet 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 hyclate 50 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 87
- Coverage rate
- 1.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,121,486
- Total spending
- $117,340,524
- Avg per beneficiary
- $28.47
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering doxycycline hyclate 50 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering doxycycline hyclate 50 MG Oral Tablet
85 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | No | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | No | $15.20 | IL |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | No | $21.70 | NH |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | No | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | No | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | No | $58.80 | NY |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T2 | No | $0 | OH |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T2 | No | $0 | OH, WV |
| The Health Plan SecureCare Capitol Plan (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T2 | No | $0 | WV |
| The Health Plan SecureChoice Optimum (PPO) | THP INSURANCE COMPANY | T2 | No | $0 | OH, WV |
| WellSense Signature (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T2 | No | $0 | NH |
| WellSense Signature Access (PPO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T2 | No | $0 | NH |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T2 | No | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T2 | No | $0 | AR, MO |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T2 | No | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T2 | No | $0 | IN, KY |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T2 | No | $0 | IL |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T2 | No | $0 | IL, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T2 | No | $0 | AR, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T2 | No | $0 | IL |
| CareSource Dual Advantage Plus (HMO D-SNP) | CARESOURCE GEORGIA CO. | T2 | No | $0 | GA |
| CareSource MyCare Ohio (HMO D-SNP) | CARESOURCE OHIO, INC. | T2 | No | $0 | OH |
| Blue adVantage Liberty (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T2 | No | $0 | LA |
| Blue adVantage Thrive (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T2 | No | $0 | LA |
| Blue adVantage Classic (HMO-POS) | HMO LOUISIANA, INC. | T2 | No | $0 | LA |
| Blue adVantage Giveback (HMO-POS) | HMO LOUISIANA, INC. | T2 | No | $0 | LA |
| Medica Advantage Solution H6154-001 (HMO-POS) | MEDICA HEALTH PLANS | T2 | No | $0 | MN |
| Medica Advantage Solution H8889-005 (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | MN |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | IA, NE |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | ND |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | ND |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | IA, NE |
| Medica Advantage Dual (PPO D-SNP) | MEDICA HEALTH PLANS | T2 | No | $0 | ND |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | SD |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T2 | No | $0 | SD |
| Medica DUAL Solution (HMO D-SNP) | MEDICA HEALTH PLANS | T2 | No | $0 | MN |
| Cooperative Medicare Advantage (HMO) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T2 | No | $0 | WI |
| Banner Medicare Advantage Dual (HMO D-SNP) | BANNER - UNIVERSITY CARE ADVANTAGE | T2 | No | $0 | AZ |
| Banner Medicare Advantage Dual (HMO D-SNP) | BANNER - UNIVERSITY CARE ADVANTAGE | T2 | No | $0 | AZ |
| Banner Medicare Advantage Prime (HMO) | BANNER HEALTH PLAN, INC. | T2 | No | $0 | AZ |
Frequently Asked Questions
Is doxycycline hyclate 50 MG Oral Tablet covered by Medicare Part D?
Yes, doxycycline hyclate 50 MG Oral Tablet is covered by 87 Medicare Part D plans (1.7% of all Part D formularies).
What tier is doxycycline hyclate 50 MG Oral Tablet on Medicare Part D plans?
doxycycline hyclate 50 MG Oral Tablet averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does doxycycline hyclate 50 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for doxycycline hyclate 50 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on doxycycline hyclate 50 MG Oral Tablet?
In 2023, total Medicare Part D spending on doxycycline hyclate 50 MG Oral Tablet 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.