doxycycline monohydrate 150 MG Oral Capsule
doxycycline monohydrate
RxCUI: 728207
What the CMS Formulary Data Shows for doxycycline monohydrate 150 MG Oral Capsule
Per the CMS 2026 Part D formulary file, doxycycline monohydrate 150 MG Oral Capsule (RxNorm concept RXCUI 728207, generic name doxycycline monohydrate) appears on 13 distinct formulary files spanning 734 Medicare Part D plan offerings - 14.5% 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 2.8.
Real-world access to doxycycline monohydrate 150 MG Oral Capsule 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 Capsule 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 Capsule today.
Coverage Details
- Formularies covering
- 13
- Plans covering
- 734
- Coverage rate
- 14.5%
- 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 Capsule
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 |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Inspired by women for women (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
Frequently Asked Questions
Is doxycycline monohydrate 150 MG Oral Capsule covered by Medicare Part D?
Yes, doxycycline monohydrate 150 MG Oral Capsule is covered by 734 Medicare Part D plans (14.5% of all Part D formularies).
What tier is doxycycline monohydrate 150 MG Oral Capsule on Medicare Part D plans?
doxycycline monohydrate 150 MG Oral Capsule averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does doxycycline monohydrate 150 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for doxycycline monohydrate 150 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on doxycycline monohydrate 150 MG Oral Capsule?
In 2023, total Medicare Part D spending on doxycycline monohydrate 150 MG Oral Capsule 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.