Medicare Part D coverage · esomeprazole · RxCUI 1297761
esomeprazole 5 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 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 5 MG Granules for Oral Suspension
Per the CMS 2026 Part D formulary file, esomeprazole 5 MG Granules for Oral Suspension (RxNorm concept RXCUI 1297761, 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 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 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 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 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 5 MG Granules for Oral Suspension covered by Medicare Part D?
Yes, esomeprazole 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 5 MG Granules for Oral Suspension on Medicare Part D plans?
esomeprazole 5 MG Granules for Oral Suspension averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does esomeprazole 5 MG Granules for Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for esomeprazole 5 MG Granules for Oral Suspension. Step therapy: 0%. Quantity limits: 44.4%.
How much does Medicare spend on esomeprazole 5 MG Granules for Oral Suspension?
In 2023, total Medicare Part D spending on esomeprazole 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