doxycycline hyclate 80 MG Delayed Release Oral Tablet
doxycycline hyclate
RxCUI: 2122343
What the CMS Formulary Data Shows for doxycycline hyclate 80 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, doxycycline hyclate 80 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 2122343, generic name doxycycline hyclate) appears on 3 distinct formulary files spanning 18 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 2, with a cross-plan average of Tier 1.3.
Real-world access to doxycycline hyclate 80 MG Delayed Release 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 80 MG Delayed Release 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 80 MG Delayed Release Oral Tablet today.
Coverage Details
- Formularies covering
- 3
- Plans covering
- 18
- Coverage rate
- 0.4%
- Tier range
- Tier 1 – Tier 2
- Average tier
- Tier 1, Preferred 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
Medicare Advantage Plans (MA-PD) Covering doxycycline hyclate 80 MG Delayed Release Oral Tablet
18 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 |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| 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 |
Frequently Asked Questions
Is doxycycline hyclate 80 MG Delayed Release Oral Tablet covered by Medicare Part D?
Yes, doxycycline hyclate 80 MG Delayed Release Oral Tablet is covered by 18 Medicare Part D plans (0.4% of all Part D formularies).
What tier is doxycycline hyclate 80 MG Delayed Release Oral Tablet on Medicare Part D plans?
doxycycline hyclate 80 MG Delayed Release Oral Tablet averages Tier 1.3 across Part D plans, ranging from Tier 1 to Tier 2.
Does doxycycline hyclate 80 MG Delayed Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for doxycycline hyclate 80 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on doxycycline hyclate 80 MG Delayed Release Oral Tablet?
In 2023, total Medicare Part D spending on doxycycline hyclate 80 MG Delayed Release 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.