escitalopram 5 MG Oral Tablet

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escitalopram

RxCUI: 351249

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
100%
Plan Coverage
5,067
Plans Covering
T1.2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for escitalopram 5 MG Oral Tablet

Per the CMS 2026 Part D formulary file, escitalopram 5 MG Oral Tablet (RxNorm concept RXCUI 351249, generic name escitalopram) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.2.

Real-world access to escitalopram 5 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 33.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,538,742 Part D beneficiaries filled escitalopram 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $171,914,954 and an average per-beneficiary annual cost of $67.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry escitalopram 5 MG Oral Tablet today.

Coverage Details

Formularies covering
330
Plans covering
5,067
Coverage rate
100%
Tier range
Tier 1 – Tier 4
Average tier
Tier 1, Preferred Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
33.3% of formularies

2023 Medicare Spending

Beneficiaries
2,538,742
Total spending
$171,914,954
Avg per beneficiary
$67.72

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering escitalopram 5 MG Oral Tablet

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T1 No $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T1 No $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T1 No $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T1 No $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials from UHC AZ-1 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Essentials from UHC AZ-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage from UHC AZ-002P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage from UHC NV-0001 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage from UHC NV-0002 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
UHC Medicare Advantage NV-001P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage from UHC NV-0006 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage Extras from UHC AZ-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Extras from UHC AZ-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Extras from UHC CO-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
UHC Dual Complete TX-D004 (HMO-POS D-SNP) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
AARP Medicare Advantage from UHC TX-23 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX

Frequently Asked Questions

Is escitalopram 5 MG Oral Tablet covered by Medicare Part D?

Yes, escitalopram 5 MG Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).

What tier is escitalopram 5 MG Oral Tablet on Medicare Part D plans?

escitalopram 5 MG Oral Tablet averages Tier 1.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does escitalopram 5 MG Oral Tablet require prior authorization?

0% of Part D formularies require prior authorization for escitalopram 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 33.3%.

How much does Medicare spend on escitalopram 5 MG Oral Tablet?

In 2023, total Medicare Part D spending on escitalopram 5 MG Oral Tablet was $171,914,954, covering 2,538,742 beneficiaries. The average spend per beneficiary was $67.72.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial