meclofenamate 100 MG Oral Capsule

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meclofenamate

RxCUI: 618552

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.
3%
Plan Coverage
154
Plans Covering
T1.9
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for meclofenamate 100 MG Oral Capsule

Per the CMS 2026 Part D formulary file, meclofenamate 100 MG Oral Capsule (RxNorm concept RXCUI 618552, generic name meclofenamate) appears on 17 distinct formulary files spanning 154 Medicare Part D plan offerings - 3% 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 1.9.

Real-world access to meclofenamate 100 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 11.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 153 Part D beneficiaries filled meclofenamate 100 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $255,302 and an average per-beneficiary annual cost of $1,668.64. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry meclofenamate 100 MG Oral Capsule today.

Coverage Details

Formularies covering
17
Plans covering
154
Coverage rate
3%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
11.8% of formularies

2023 Medicare Spending

Beneficiaries
153
Total spending
$255,302
Avg per beneficiary
$1,668.64

Tier Distribution Across Plans

4 plans
Tier 1, Preferred Generic
96 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering meclofenamate 100 MG Oral Capsule

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

Plan Insurer Tier PA Premium States
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
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
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T2 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T2 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T2 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T2 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T2 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T2 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T2 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T2 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T2 No $0 NV
Troy Medicare (HMO) TROY HEALTH, INC. T2 No $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) TROY HEALTH, INC. T2 No $0 NC
Contra Costa Health Care Plus (HMO D-SNP) CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH T2 No $0 CA
Keystone First VIP Choice (HMO D-SNP) VISTA HEALTH PLAN, INC. T2 No $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) VISTA HEALTH PLAN, INC. T2 No $0 PA
First Choice VIP Care (HMO D-SNP) SELECT HEALTH OF SOUTH CAROLINA, INC. T2 No $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 No $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 No $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS FLORIDA INC T2 No $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS LOUISIANA, INC. T2 No $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS NORTH CAROLINA, INC. T2 No $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH MICHIGAN, INC. T2 No $0 MI
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA

Frequently Asked Questions

Is meclofenamate 100 MG Oral Capsule covered by Medicare Part D?

Yes, meclofenamate 100 MG Oral Capsule is covered by 154 Medicare Part D plans (3% of all Part D formularies).

What tier is meclofenamate 100 MG Oral Capsule on Medicare Part D plans?

meclofenamate 100 MG Oral Capsule averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does meclofenamate 100 MG Oral Capsule require prior authorization?

0% of Part D formularies require prior authorization for meclofenamate 100 MG Oral Capsule. Step therapy: 0%. Quantity limits: 11.8%.

How much does Medicare spend on meclofenamate 100 MG Oral Capsule?

In 2023, total Medicare Part D spending on meclofenamate 100 MG Oral Capsule was $255,302, covering 153 beneficiaries. The average spend per beneficiary was $1,668.64.

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