Medicare Part D coverage · indomethacin · RxCUI 197817
indomethacin 25 MG Oral Capsule
Per the CMS 2026 Part D formulary file, indomethacin 25 MG Oral Capsule is covered by 2,907 Medicare Part D plans (57.5% of enrollable products), averaging Tier 1.7, with prior authorization required on 20.6% of covering formularies.
- 57.5%
- Plan coverage
- 2,907
- Plans covering
- T1.7
- Avg tier
- 20.6%
- Prior auth required
What the CMS Formulary Data Shows for indomethacin 25 MG Oral Capsule
Per the CMS 2026 Part D formulary file, indomethacin 25 MG Oral Capsule (RxNorm concept RXCUI 197817, generic name indomethacin) appears on 199 distinct formulary files spanning 2,907 Medicare Part D plan offerings - 57.5% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.7.
Real-world access to indomethacin 25 MG Oral Capsule depends on utilization management as much as tier placement: 20.6% of covering formularies require prior authorization. 0% require step therapy. 17.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 123,532 Part D beneficiaries filled indomethacin 25 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $3,235,993 and an average per-beneficiary annual cost of $26.20. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry indomethacin 25 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 199
- Plans covering
- 2,907
- Coverage rate
- 57.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 20.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 17.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 123,532
- Total spending
- $3,235,993
- Avg per beneficiary
- $26.20
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering indomethacin 25 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 | Yes | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T1 | Yes | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T1 | Yes | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T1 | Yes | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T1 | Yes | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T1 | Yes | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T1 | Yes | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T1 | Yes | $0 | TN |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
Show the next 30 plans
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is indomethacin 25 MG Oral Capsule covered by Medicare Part D?
Yes, indomethacin 25 MG Oral Capsule is covered by 2,907 Medicare Part D plans (57.5% of all Part D formularies).
What tier is indomethacin 25 MG Oral Capsule on Medicare Part D plans?
indomethacin 25 MG Oral Capsule averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does indomethacin 25 MG Oral Capsule require prior authorization?
20.6% of Part D formularies require prior authorization for indomethacin 25 MG Oral Capsule. Step therapy: 0%. Quantity limits: 17.6%.
How much does Medicare spend on indomethacin 25 MG Oral Capsule?
In 2023, total Medicare Part D spending on indomethacin 25 MG Oral Capsule was $3,235,993, covering 123,532 beneficiaries. The average spend per beneficiary was $26.20.
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
- cilostazol 100 MG Oral Tablet T1.7
- dorzolamide 20 MG/ML Ophthalmic Solution T1.7
- erythromycin 0.005 MG/MG Ophthalmic Ointment T1.7
- zolpidem tartrate 10 MG Oral Tablet T1.7
- diclofenac sodium 75 MG Delayed Release Oral Tablet T1.7
- amiloride hydrochloride 5 MG / hydrochlorothiazide 50 MG Oral Tablet T1.7
Similar prior-authorization rate
- mercaptopurine 20 MG/ML Oral Suspension 20.7% PA
- patiromer 1000 MG Powder for Oral Suspension [Veltassa] 20.7% PA
- insulin, regular, human 100 UNT/ML Injectable Solution [Novolin R] 20.7% PA
- 24 HR amphetamine aspartate 5 MG / amphetamine sulfate 5 MG / dextroamphetamine saccharate 5 MG / dextroamphetamine sulfate 5 MG Extended Release Oral Capsule 20.4% PA
- linezolid 20 MG/ML Oral Suspension 20.9% PA
- 24 HR amphetamine aspartate 2.5 MG / amphetamine sulfate 2.5 MG / dextroamphetamine saccharate 2.5 MG / dextroamphetamine sulfate 2.5 MG Extended Release Oral Capsule 20.3% PA