doxycycline monohydrate 150 MG Oral Tablet
doxycycline monohydrate
RxCUI: 1650444
What the CMS Formulary Data Shows for doxycycline monohydrate 150 MG Oral Tablet
Per the CMS 2026 Part D formulary file, doxycycline monohydrate 150 MG Oral Tablet (RxNorm concept RXCUI 1650444, generic name doxycycline monohydrate) appears on 74 distinct formulary files spanning 2,175 Medicare Part D plan offerings - 42.9% 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 2.7.
Real-world access to doxycycline monohydrate 150 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 1,315,899 Part D beneficiaries filled doxycycline monohydrate 150 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $35,152,509 and an average per-beneficiary annual cost of $26.71. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxycycline monohydrate 150 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 74
- Plans covering
- 2,175
- Coverage rate
- 42.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,315,899
- Total spending
- $35,152,509
- Avg per beneficiary
- $26.71
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering doxycycline monohydrate 150 MG Oral Tablet
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 |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T1 | No | $51.60 | NY |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
Frequently Asked Questions
Is doxycycline monohydrate 150 MG Oral Tablet covered by Medicare Part D?
Yes, doxycycline monohydrate 150 MG Oral Tablet is covered by 2,175 Medicare Part D plans (42.9% of all Part D formularies).
What tier is doxycycline monohydrate 150 MG Oral Tablet on Medicare Part D plans?
doxycycline monohydrate 150 MG Oral Tablet averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does doxycycline monohydrate 150 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for doxycycline monohydrate 150 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on doxycycline monohydrate 150 MG Oral Tablet?
In 2023, total Medicare Part D spending on doxycycline monohydrate 150 MG Oral Tablet was $35,152,509, covering 1,315,899 beneficiaries. The average spend per beneficiary was $26.71.
Read our methodology - how this data is sourced, computed, and verified.