Medicare Part D coverage · lofexidine · RxCUI 2046591
lofexidine 0.18 MG Oral Tablet
Per the CMS 2026 Part D formulary file, lofexidine 0.18 MG Oral Tablet is covered by 303 Medicare Part D plans (6% of enrollable products), averaging Tier 4.4, with prior authorization required on 46.2% of covering formularies.
- 6%
- Plan coverage
- 303
- Plans covering
- T4.4
- Avg tier
- 46.2%
- Prior auth required
What the CMS Formulary Data Shows for lofexidine 0.18 MG Oral Tablet
Per the CMS 2026 Part D formulary file, lofexidine 0.18 MG Oral Tablet (RxNorm concept RXCUI 2046591, generic name lofexidine) appears on 39 distinct formulary files spanning 303 Medicare Part D plan offerings - 6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.4.
Real-world access to lofexidine 0.18 MG Oral Tablet depends on utilization management as much as tier placement: 46.2% of covering formularies require prior authorization. 0% require step therapy. 61.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 781 Part D beneficiaries filled lofexidine 0.18 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $3,148,076 and an average per-beneficiary annual cost of $4,030.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lofexidine 0.18 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 39
- Plans covering
- 303
- Coverage rate
- 6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 46.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 61.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 781
- Total spending
- $3,148,076
- Avg per beneficiary
- $4,030.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lofexidine 0.18 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T4 | No | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T4 | No | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T4 | No | $0 | TN |
| Health First Rewards H1099-014 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Value H1099-006 (HMO) | Health First Health Plans | T4 | No | $15.00 | FL |
| Health First Classic H1099-001 (HMO-POS) | Health First Health Plans | T4 | No | $49.40 | FL |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T5 | No | $0 | NY |
Show the next 30 plans
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T5 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | Highmark Choice Company | T5 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | No | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | No | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | Highmark Choice Company | T5 | No | $0 | PA |
| Complete Blue HMO Distinct (HMO) | Highmark Choice Company | T5 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Solutions Company | T5 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | No | $0 | WV |
| Complete Blue PPO Merit (PPO) | Highmark Senior Solutions Company | T5 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Bcbsd Inc. | T5 | No | $0 | DE |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is lofexidine 0.18 MG Oral Tablet covered by Medicare Part D?
Yes, lofexidine 0.18 MG Oral Tablet is covered by 303 Medicare Part D plans (6% of all Part D formularies).
What tier is lofexidine 0.18 MG Oral Tablet on Medicare Part D plans?
lofexidine 0.18 MG Oral Tablet averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does lofexidine 0.18 MG Oral Tablet require prior authorization?
46.2% of Part D formularies require prior authorization for lofexidine 0.18 MG Oral Tablet. Step therapy: 0%. Quantity limits: 61.5%.
How much does Medicare spend on lofexidine 0.18 MG Oral Tablet?
In 2023, total Medicare Part D spending on lofexidine 0.18 MG Oral Tablet was $3,148,076, covering 781 beneficiaries. The average spend per beneficiary was $4,030.83.
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
- 20 ML pegcetacoplan 54 MG/ML Injection [Empaveli] T4.4
- fostamatinib 100 MG Oral Tablet [Tavalisse] T4.5
- 0.5 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio] T4.4
- 0.8 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio] T4.4
- 168 HR granisetron 0.129 MG/HR Transdermal System [Sancuso] T4.4
- chenodeoxycholate 250 MG Oral Tablet [Ctexli] T4.4
Similar prior-authorization rate
- istradefylline 20 MG Oral Tablet [Nourianz] 46.2% PA
- isotretinoin 10 MG Oral Capsule [Accutane] 46.3% PA
- promethazine hydrochloride 50 MG Rectal Suppository [Promethegan] 46.3% PA
- hydroxyzine pamoate 25 MG Oral Capsule 46.1% PA
- isotretinoin 20 MG Oral Capsule [Accutane] 46.4% PA
- isotretinoin 40 MG Oral Capsule [Accutane] 46.6% PA