hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet

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hydrochlorothiazide

RxCUI: 866491

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.
91%
Plan Coverage
4,612
Plans Covering
T2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet

Per the CMS 2026 Part D formulary file, hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet (RxNorm concept RXCUI 866491, generic name hydrochlorothiazide) appears on 258 distinct formulary files spanning 4,612 Medicare Part D plan offerings - 91% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.

Real-world access to hydrochlorothiazide 50 MG / metoprolol tartrate 100 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 50 MG / metoprolol tartrate 100 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 50 MG / metoprolol tartrate 100 MG Oral Tablet today.

Coverage Details

Formularies covering
258
Plans covering
4,612
Coverage rate
91%
Tier range
Tier 1 – Tier 3
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

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering hydrochlorothiazide 50 MG / metoprolol tartrate 100 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
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
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 Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL

Frequently Asked Questions

Is hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet covered by Medicare Part D?

Yes, hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet is covered by 4,612 Medicare Part D plans (91% of all Part D formularies).

What tier is hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet on Medicare Part D plans?

hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 3.

Does hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet require prior authorization?

0% of Part D formularies require prior authorization for hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet?

In 2023, total Medicare Part D spending on hydrochlorothiazide 50 MG / metoprolol tartrate 100 MG Oral Tablet was $98,660,150, covering 4,902,174 beneficiaries. The average spend per beneficiary was $20.13.

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