esomeprazole 2.5 MG Granules for Oral Suspension
esomeprazole
RxCUI: 1297658
What the CMS Formulary Data Shows for esomeprazole 2.5 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 2.5 MG Granules for Oral Suspension (RxNorm concept RXCUI 1297658, generic name esomeprazole) appears on 9 distinct formulary files spanning 84 Medicare Part D plan offerings - 1.7% 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 2.5 MG Granules for Oral Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 44.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 685,529 Part D beneficiaries filled esomeprazole 2.5 MG Granules for Oral Suspension in 2023, with total plan-and-beneficiary spending of $172,016,821 and an average per-beneficiary annual cost of $250.93. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry esomeprazole 2.5 MG Granules for Oral Suspension today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 84
- Coverage rate
- 1.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 44.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 685,529
- Total spending
- $172,016,821
- Avg per beneficiary
- $250.93
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering esomeprazole 2.5 MG Granules for Oral Suspension
84 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| 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 |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Samaritan Dual Advantage (HMO D-SNP) | SAMARITAN HEALTH PLANS, INC. | T2 | No | $10.50 | OR |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | No | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | No | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | No | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | No | $0 | AZ |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health AllCare Preferred (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Platinum + Instacart (HMO-POS) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Harmony (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Balance (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health the ONE (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health CommUnity (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health smartSavings (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health My Choice Select (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health My Choice CalCare (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Honor+ Plan (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health ValorCare (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health L.A. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health S.D. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T4 | No | $0 | CA |
| Alignment Health Platinum (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NC |
| Alignment Health NC Duals (HMO-POS D-SNP) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NC |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NC |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NV |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NV |
| Alignment Health Platinum Select (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NC |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | No | $0 | NC |
| Alignment Health the ONE + Walgreens (HMO-POS) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health Heart & Diabetes (HMO-POS C-SNP) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health smartHMO (HMO-POS) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health Dual Select+ (HMO-POS D-SNP) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health Total Dual+ (HMO-POS D-SNP) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health smartSavings (HMO-POS) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | No | $0 | TX |
| Alignment Health Advantage PPO (PPO) | ALIGNMENT HEALTH ADVANTAGE PLAN INC | T4 | No | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF NEVADA, INC. | T4 | No | $0 | NV |
| Alignment Health the ONE (HMO D-SNP) | ALIGNMENT HEALTH PLAN OF NEVADA, INC. | T4 | No | $0 | NV |
Frequently Asked Questions
Is esomeprazole 2.5 MG Granules for Oral Suspension covered by Medicare Part D?
Yes, esomeprazole 2.5 MG Granules for Oral Suspension is covered by 84 Medicare Part D plans (1.7% of all Part D formularies).
What tier is esomeprazole 2.5 MG Granules for Oral Suspension on Medicare Part D plans?
esomeprazole 2.5 MG Granules for Oral Suspension averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does esomeprazole 2.5 MG Granules for Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for esomeprazole 2.5 MG Granules for Oral Suspension. Step therapy: 0%. Quantity limits: 44.4%.
How much does Medicare spend on esomeprazole 2.5 MG Granules for Oral Suspension?
In 2023, total Medicare Part D spending on esomeprazole 2.5 MG Granules for Oral Suspension was $172,016,821, covering 685,529 beneficiaries. The average spend per beneficiary was $250.93.
Read our methodology - how this data is sourced, computed, and verified.