Medicare Part D coverage · doxycycline monohydrate · RxCUI 728207
doxycycline monohydrate 150 MG Oral Capsule
Per the CMS 2026 Part D formulary file, doxycycline monohydrate 150 MG Oral Capsule is covered by 734 Medicare Part D plans (14.5% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 14.5%
- Plan coverage
- 734
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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.
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