fluoxetine 50 MG / olanzapine 6 MG Oral Capsule

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fluoxetine

RxCUI: 403972

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
8.2%
Plan Coverage
416
Plans Covering
T3.1
Avg Tier
7.7%
Prior Auth Required

What the CMS Formulary Data Shows for fluoxetine 50 MG / olanzapine 6 MG Oral Capsule

Per the CMS 2026 Part D formulary file, fluoxetine 50 MG / olanzapine 6 MG Oral Capsule (RxNorm concept RXCUI 403972, generic name fluoxetine) appears on 26 distinct formulary files spanning 416 Medicare Part D plan offerings - 8.2% 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 3.1.

Real-world access to fluoxetine 50 MG / olanzapine 6 MG Oral Capsule depends on utilization management as much as tier placement: 7.7% of covering formularies require prior authorization. 0% require step therapy. 23.1% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,427,221 Part D beneficiaries filled fluoxetine 50 MG / olanzapine 6 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $104,951,776 and an average per-beneficiary annual cost of $73.54. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry fluoxetine 50 MG / olanzapine 6 MG Oral Capsule today.

Coverage Details

Formularies covering
26
Plans covering
416
Coverage rate
8.2%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
7.7% of formularies
Step therapy required
0% of formularies
Quantity limits
23.1% of formularies

2023 Medicare Spending

Beneficiaries
1,427,221
Total spending
$104,951,776
Avg per beneficiary
$73.54

Tier Distribution Across Plans

8 plans
Tier 1, Preferred Generic
92 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering fluoxetine 50 MG / olanzapine 6 MG Oral Capsule

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
MCS Classicare RxMax (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino Ideal (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Efectivo (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Essential (HMO-POS) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino Progreso (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Primero (HMO C-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Firme (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare En Tu Hogar (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Hero (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino Total (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare InteliCare (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino Maximo (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Excede (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Estrella (HMO) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino Superior (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
MCS Classicare Platino 185 (HMO D-SNP) MCS ADVANTAGE, INC. T2 No $0 PR
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
MMM Supremo (HMO C-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Unico (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Elite (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Deluxe (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
PMC Max (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Plenitud (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Valioso (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Grandioso (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Mega Flex (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Relax Platino (HMO D-SNP) MMM HEALTHCARE, LLC T2 No $0 PR
MMM Balance (HMO-POS) MMM HEALTHCARE, LLC T2 No $0 PR
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA

Frequently Asked Questions

Is fluoxetine 50 MG / olanzapine 6 MG Oral Capsule covered by Medicare Part D?

Yes, fluoxetine 50 MG / olanzapine 6 MG Oral Capsule is covered by 416 Medicare Part D plans (8.2% of all Part D formularies).

What tier is fluoxetine 50 MG / olanzapine 6 MG Oral Capsule on Medicare Part D plans?

fluoxetine 50 MG / olanzapine 6 MG Oral Capsule averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does fluoxetine 50 MG / olanzapine 6 MG Oral Capsule require prior authorization?

7.7% of Part D formularies require prior authorization for fluoxetine 50 MG / olanzapine 6 MG Oral Capsule. Step therapy: 0%. Quantity limits: 23.1%.

How much does Medicare spend on fluoxetine 50 MG / olanzapine 6 MG Oral Capsule?

In 2023, total Medicare Part D spending on fluoxetine 50 MG / olanzapine 6 MG Oral Capsule was $104,951,776, covering 1,427,221 beneficiaries. The average spend per beneficiary was $73.54.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial