Medicare Part D coverage · memantine hydrochloride · RxCUI 996571
memantine hydrochloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, memantine hydrochloride 5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.9, with prior authorization required on 50% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.9
- Avg tier
- 50%
- Prior auth required
What the CMS Formulary Data Shows for memantine hydrochloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, memantine hydrochloride 5 MG Oral Tablet (RxNorm concept RXCUI 996571, generic name memantine hydrochloride) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 1.9.
Real-world access to memantine hydrochloride 5 MG Oral Tablet depends on utilization management as much as tier placement: 50% of covering formularies require prior authorization. 0% require step therapy. 30.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 892,907 Part D beneficiaries filled memantine hydrochloride 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $207,922,964 and an average per-beneficiary annual cost of $232.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry memantine hydrochloride 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 50% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 30.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 892,907
- Total spending
- $207,922,964
- Avg per beneficiary
- $232.86
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering memantine hydrochloride 5 MG Oral Tablet
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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $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 |
| Anthem Select (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Select (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Select (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Select (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Select (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | Yes | $0 | CA |
Show the next 30 plans
| Wellpoint Medicare Advantage (HMO-POS) | Wellpoint Health Plans, Inc. | T1 | Yes | $0 | AZ |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Prime (HMO-POS) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | HMO Colorado, Inc. | T1 | Yes | $0 | NV |
| Anthem Full Dual Advantage (HMO D-SNP) | HMO Colorado, Inc. | T1 | Yes | $0 | NV |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | HMO Colorado, Inc. | T1 | Yes | $0 | NV |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | Blue Cross OF California Partnership Plan, Inc. | T1 | Yes | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is memantine hydrochloride 5 MG Oral Tablet covered by Medicare Part D?
Yes, memantine hydrochloride 5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is memantine hydrochloride 5 MG Oral Tablet on Medicare Part D plans?
memantine hydrochloride 5 MG Oral Tablet averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 6.
Does memantine hydrochloride 5 MG Oral Tablet require prior authorization?
50% of Part D formularies require prior authorization for memantine hydrochloride 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 30.8%.
How much does Medicare spend on memantine hydrochloride 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on memantine hydrochloride 5 MG Oral Tablet was $207,922,964, covering 892,907 beneficiaries. The average spend per beneficiary was $232.86.
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
- 24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule T1.9
- cephalexin 25 MG/ML Oral Suspension T1.9
- haloperidol 5 MG Oral Tablet T1.9
- methylprednisolone 32 MG Oral Tablet T1.9
- Atrial Fibrillation sotalol hydrochloride 120 MG Oral Tablet T1.9
- Atrial Fibrillation sotalol hydrochloride 160 MG Oral Tablet T1.9
Similar prior-authorization rate
- 0.2 ML adalimumab-atto 50 MG/ML Prefilled Syringe [Amjevita] 50% PA
- prednisolone 15 MG Disintegrating Oral Tablet [Orapred] 50% PA
- trazodone hydrochloride 10 MG/ML Oral Solution [Raldesy] 50% PA
- lactulose 20000 MG Powder for Oral Solution 50% PA
- 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] 50% PA
- 72 HR fentanyl 0.075 MG/HR Transdermal System 50% PA