hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet
hydrochlorothiazide
RxCUI: 866482
What the CMS Formulary Data Shows for hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet
Per the CMS 2026 Part D formulary file, hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet (RxNorm concept RXCUI 866482, generic name hydrochlorothiazide) appears on 302 distinct formulary files spanning 4,724 Medicare Part D plan offerings - 93.2% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.1.
Real-world access to hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,902,174 Part D beneficiaries filled hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $98,660,150 and an average per-beneficiary annual cost of $20.13. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 302
- Plans covering
- 4,724
- Coverage rate
- 93.2%
- 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
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,902,174
- Total spending
- $98,660,150
- Avg per beneficiary
- $20.13
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (PPO C-SNP) | SILVERSCRIPT INSURANCE COMPANY | T1 | No | $0 | GA |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | KS, MO |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | IL |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | MO |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH INC. (GA) | T1 | No | $0 | NC |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH INC. (GA) | T1 | No | $0 | SC |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF MICHIGAN INC. | T1 | No | $0 | MI |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH, INC. (LA) | T1 | No | $0 | LA |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (NY) | T1 | No | $0 | NY |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | AZ |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | NV |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | PA |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | DE |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (TX) | T1 | No | $0 | TX |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (TX) | T1 | No | $0 | TX |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (GA) | T1 | No | $0 | GA |
| Sentara Community Complete Select (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage (HMO-POS) | WELLPOINT WEST VIRGINIA , INC. | T1 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
Frequently Asked Questions
Is hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet covered by Medicare Part D?
Yes, hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet is covered by 4,724 Medicare Part D plans (93.2% of all Part D formularies).
What tier is hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet on Medicare Part D plans?
hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet?
In 2023, total Medicare Part D spending on hydrochlorothiazide 25 MG / metoprolol tartrate 50 MG Oral Tablet was $98,660,150, covering 4,902,174 beneficiaries. The average spend per beneficiary was $20.13.
Read our methodology - how this data is sourced, computed, and verified.