levocetirizine dihydrochloride 0.5 MG/ML Oral Solution

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levocetirizine dihydrochloride

RxCUI: 855168

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.
47.9%
Plan Coverage
2,427
Plans Covering
T2.7
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for levocetirizine dihydrochloride 0.5 MG/ML Oral Solution

Per the CMS 2026 Part D formulary file, levocetirizine dihydrochloride 0.5 MG/ML Oral Solution (RxNorm concept RXCUI 855168, generic name levocetirizine dihydrochloride) appears on 145 distinct formulary files spanning 2,427 Medicare Part D plan offerings - 47.9% 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 2.7.

Real-world access to levocetirizine dihydrochloride 0.5 MG/ML Oral Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 1.4% require step therapy. 44.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 642,854 Part D beneficiaries filled levocetirizine dihydrochloride 0.5 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $38,000,182 and an average per-beneficiary annual cost of $59.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levocetirizine dihydrochloride 0.5 MG/ML Oral Solution today.

Coverage Details

Formularies covering
145
Plans covering
2,427
Coverage rate
47.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
1.4% of formularies
Quantity limits
44.8% of formularies

2023 Medicare Spending

Beneficiaries
642,854
Total spending
$38,000,182
Avg per beneficiary
$59.11

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering levocetirizine dihydrochloride 0.5 MG/ML Oral Solution

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
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
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
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

Frequently Asked Questions

Is levocetirizine dihydrochloride 0.5 MG/ML Oral Solution covered by Medicare Part D?

Yes, levocetirizine dihydrochloride 0.5 MG/ML Oral Solution is covered by 2,427 Medicare Part D plans (47.9% of all Part D formularies).

What tier is levocetirizine dihydrochloride 0.5 MG/ML Oral Solution on Medicare Part D plans?

levocetirizine dihydrochloride 0.5 MG/ML Oral Solution averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.

Does levocetirizine dihydrochloride 0.5 MG/ML Oral Solution require prior authorization?

0% of Part D formularies require prior authorization for levocetirizine dihydrochloride 0.5 MG/ML Oral Solution. Step therapy: 1.4%. Quantity limits: 44.8%.

How much does Medicare spend on levocetirizine dihydrochloride 0.5 MG/ML Oral Solution?

In 2023, total Medicare Part D spending on levocetirizine dihydrochloride 0.5 MG/ML Oral Solution was $38,000,182, covering 642,854 beneficiaries. The average spend per beneficiary was $59.11.

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