Medicare Part D coverage · esomeprazole · RxCUI 1297658
esomeprazole 2.5 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 2.5 MG Granules for Oral Suspension is covered by 84 Medicare Part D plans (1.7% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.
- 1.7%
- Plan coverage
- 84
- Plans covering
- T2.4
- Avg tier
- 0%
- Prior auth required
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 $172,008,188 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 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
- $172,008,188
- Avg per beneficiary
- $250.91
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 84 plans.
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 $172,008,188, 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
- aripiprazole 15 MG Oral Tablet T2.4
- candesartan cilexetil 16 MG Oral Tablet T2.4
- potassium citrate 10 MEQ Extended Release Oral Tablet T2.4
- cholestyramine resin 4000 MG Powder for Oral Suspension T2.4
- candesartan cilexetil 4 MG Oral Tablet T2.4
- potassium citrate 15 MEQ Extended Release Oral Tablet T2.4
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