hydroxyurea 100 MG Oral Tablet [Siklos]

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hydroxyurea

RxCUI: 1999314

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.
25.8%
Plan Coverage
1,307
Plans Covering
T3.4
Avg Tier
11%
Prior Auth Required

What the CMS Formulary Data Shows for hydroxyurea 100 MG Oral Tablet [Siklos]

Per the CMS 2026 Part D formulary file, hydroxyurea 100 MG Oral Tablet [Siklos] (RxNorm concept RXCUI 1999314, generic name hydroxyurea) appears on 73 distinct formulary files spanning 1,307 Medicare Part D plan offerings - 25.8% 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 3.4.

Real-world access to hydroxyurea 100 MG Oral Tablet [Siklos] depends on utilization management as much as tier placement: 11% 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 102,368 Part D beneficiaries filled hydroxyurea 100 MG Oral Tablet [Siklos] in 2023, with total plan-and-beneficiary spending of $17,214,624 and an average per-beneficiary annual cost of $168.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydroxyurea 100 MG Oral Tablet [Siklos] today.

Coverage Details

Formularies covering
73
Plans covering
1,307
Coverage rate
25.8%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
11% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
102,368
Total spending
$17,214,624
Avg per beneficiary
$168.16

Tier Distribution Across Plans

25 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
16 plans
Tier 3, Preferred Brand
58 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering hydroxyurea 100 MG Oral Tablet [Siklos]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
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
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
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) ELDERPLAN, INC. T1 No $44.80 NY
MetroPlus Platinum Plan (HMO) METROPLUS HEALTH PLAN, INC. T1 No $58.80 NY
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 No $0 CA
MMM Supremo (HMO C-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Unico (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Elite (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Deluxe (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
PMC Max (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Plenitud (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Valioso (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Grandioso (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Mega Flex (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Relax Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Balance (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 Yes $0 CA

Frequently Asked Questions

Is hydroxyurea 100 MG Oral Tablet [Siklos] covered by Medicare Part D?

Yes, hydroxyurea 100 MG Oral Tablet [Siklos] is covered by 1,307 Medicare Part D plans (25.8% of all Part D formularies).

What tier is hydroxyurea 100 MG Oral Tablet [Siklos] on Medicare Part D plans?

hydroxyurea 100 MG Oral Tablet [Siklos] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does hydroxyurea 100 MG Oral Tablet [Siklos] require prior authorization?

11% of Part D formularies require prior authorization for hydroxyurea 100 MG Oral Tablet [Siklos]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on hydroxyurea 100 MG Oral Tablet [Siklos]?

In 2023, total Medicare Part D spending on hydroxyurea 100 MG Oral Tablet [Siklos] was $17,214,624, covering 102,368 beneficiaries. The average spend per beneficiary was $168.16.

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