doxycycline hyclate 20 MG Oral Tablet
doxycycline hyclate
RxCUI: 283535
What the CMS Formulary Data Shows for doxycycline hyclate 20 MG Oral Tablet
Per the CMS 2026 Part D formulary file, doxycycline hyclate 20 MG Oral Tablet (RxNorm concept RXCUI 283535, generic name doxycycline hyclate) appears on 328 distinct formulary files spanning 5,057 Medicare Part D plan offerings - 99.8% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.
Real-world access to doxycycline hyclate 20 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.6% 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 20 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 20 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,057
- Coverage rate
- 99.8%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0.6% 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 20 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage (HMO-POS) | WELLPOINT WEST VIRGINIA , INC. | T1 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Anthem Select (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Select (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Select (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Select (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Select (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Wellpoint Medicare Advantage (HMO-POS) | WELLPOINT HEALTH PLANS, INC. | T1 | No | $0 | AZ |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Prime (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | HMO COLORADO, INC. | T1 | No | $0 | NV |
| Anthem Full Dual Advantage (HMO D-SNP) | HMO COLORADO, INC. | T1 | No | $0 | NV |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | HMO COLORADO, INC. | T1 | No | $0 | NV |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | No | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
Frequently Asked Questions
Is doxycycline hyclate 20 MG Oral Tablet covered by Medicare Part D?
Yes, doxycycline hyclate 20 MG Oral Tablet is covered by 5,057 Medicare Part D plans (99.8% of all Part D formularies).
What tier is doxycycline hyclate 20 MG Oral Tablet on Medicare Part D plans?
doxycycline hyclate 20 MG Oral Tablet averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 6.
Does doxycycline hyclate 20 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for doxycycline hyclate 20 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0.6%.
How much does Medicare spend on doxycycline hyclate 20 MG Oral Tablet?
In 2023, total Medicare Part D spending on doxycycline hyclate 20 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.