Medicare Part D coverage · doxycycline hyclate · RxCUI 1652674
doxycycline hyclate 50 MG Oral Tablet
Per the CMS 2026 Part D formulary file, doxycycline hyclate 50 MG Oral Tablet is covered by 87 Medicare Part D plans (1.7% of enrollable products), averaging Tier 1.7, with prior authorization required on 0% of covering formularies.
- 1.7%
- Plan coverage
- 87
- Plans covering
- T1.7
- Avg tier
- 0%
- Prior auth required
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 $117,336,811 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
- $117,336,811
- 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 |
Show the next 30 plans
| 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 |
Showing top 50 of 85 plans.
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 $117,336,811, covering 4,121,486 beneficiaries. The average spend per beneficiary was $28.47.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA