Medicare Part D coverage · fluoxetine · RxCUI 313995
fluoxetine 90 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, fluoxetine 90 MG Delayed Release Oral Capsule is covered by 2,300 Medicare Part D plans (45.5% of enrollable products), averaging Tier 2.9, with prior authorization required on 0% of covering formularies.
- 45.5%
- Plan coverage
- 2,300
- Plans covering
- T2.9
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for fluoxetine 90 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, fluoxetine 90 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 313995, generic name fluoxetine) appears on 82 distinct formulary files spanning 2,300 Medicare Part D plan offerings - 45.5% 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 2.9.
Real-world access to fluoxetine 90 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 62.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,427,221 Part D beneficiaries filled fluoxetine 90 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $104,943,337 and an average per-beneficiary annual cost of $73.53. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry fluoxetine 90 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 82
- Plans covering
- 2,300
- Coverage rate
- 45.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 62.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,427,221
- Total spending
- $104,943,337
- Avg per beneficiary
- $73.53
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering fluoxetine 90 MG Delayed Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| 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 |
| 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 |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
Show the next 30 plans
| Wellpoint Medicare Advantage (HMO-POS) | Wellpoint West Virginia , Inc. | T2 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is fluoxetine 90 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, fluoxetine 90 MG Delayed Release Oral Capsule is covered by 2,300 Medicare Part D plans (45.5% of all Part D formularies).
What tier is fluoxetine 90 MG Delayed Release Oral Capsule on Medicare Part D plans?
fluoxetine 90 MG Delayed Release Oral Capsule averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does fluoxetine 90 MG Delayed Release Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for fluoxetine 90 MG Delayed Release Oral Capsule. Step therapy: 0%. Quantity limits: 62.2%.
How much does Medicare spend on fluoxetine 90 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on fluoxetine 90 MG Delayed Release Oral Capsule was $104,943,337, covering 1,427,221 beneficiaries. The average spend per beneficiary was $73.53.
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
- atazanavir 150 MG Oral Capsule T2.9
- efavirenz 600 MG / emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet T2.9
- lopinavir 100 MG / ritonavir 25 MG Oral Tablet T2.9
- lurasidone hydrochloride 120 MG Oral Tablet T2.9
- molindone hydrochloride 10 MG Oral Tablet T2.9
- mycophenolic acid 180 MG Delayed Release Oral Tablet T2.9
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