Medicare Part D coverage · esomeprazole · RxCUI 692576
esomeprazole 20 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 20 MG Granules for Oral Suspension is covered by 250 Medicare Part D plans (4.9% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.
- 4.9%
- Plan coverage
- 250
- Plans covering
- T2.4
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for esomeprazole 20 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 20 MG Granules for Oral Suspension (RxNorm concept RXCUI 692576, generic name esomeprazole) appears on 79 distinct formulary files spanning 250 Medicare Part D plan offerings - 4.9% 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 2.4.
Real-world access to esomeprazole 20 MG Granules for Oral Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 62% require step therapy. 83.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 685,529 Part D beneficiaries filled esomeprazole 20 MG Granules for Oral Suspension in 2023, with total plan-and-beneficiary spending of $172,008,188 and an average per-beneficiary annual cost of $250.91. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry esomeprazole 20 MG Granules for Oral Suspension today.
Coverage Details
- Formularies covering
- 79
- Plans covering
- 250
- Coverage rate
- 4.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 62% of formularies
- Quantity limits
- 83.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 685,529
- Total spending
- $172,008,188
- Avg per beneficiary
- $250.91
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering esomeprazole 20 MG Granules for Oral Suspension
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| 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 |
Show the next 30 plans
| 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 |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | No | $10.50 | OR, WA |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $12.00 | CA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| KeyCare Advantage (HMO I-SNP) | Isnp Ventures, LLC | T1 | No | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | No | $23.80 | MS |
| Senior Care (HMO I-SNP) | Lifeworks Advantage, LLC | T1 | No | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | No | $27.70 | TN |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | No | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC Advantage, LLC | T1 | No | $31.00 | MO, NC, SC, TN |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $31.40 | OH |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | No | $32.70 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is esomeprazole 20 MG Granules for Oral Suspension covered by Medicare Part D?
Yes, esomeprazole 20 MG Granules for Oral Suspension is covered by 250 Medicare Part D plans (4.9% of all Part D formularies).
What tier is esomeprazole 20 MG Granules for Oral Suspension on Medicare Part D plans?
esomeprazole 20 MG Granules for Oral Suspension averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does esomeprazole 20 MG Granules for Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for esomeprazole 20 MG Granules for Oral Suspension. Step therapy: 62%. Quantity limits: 83.5%.
How much does Medicare spend on esomeprazole 20 MG Granules for Oral Suspension?
In 2023, total Medicare Part D spending on esomeprazole 20 MG Granules for Oral Suspension was $172,008,188, covering 685,529 beneficiaries. The average spend per beneficiary was $250.91.
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
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