Medicare Part D coverage · methadone hydrochloride · RxCUI 864769
methadone hydrochloride 2 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, methadone hydrochloride 2 MG/ML Oral Solution is covered by 4,402 Medicare Part D plans (87.1% of enrollable products), averaging Tier 2.4, with prior authorization required on 44.3% of covering formularies.
- 87.1%
- Plan coverage
- 4,402
- Plans covering
- T2.4
- Avg tier
- 44.3%
- Prior auth required
What the CMS Formulary Data Shows for methadone hydrochloride 2 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, methadone hydrochloride 2 MG/ML Oral Solution (RxNorm concept RXCUI 864769, generic name methadone hydrochloride) appears on 221 distinct formulary files spanning 4,402 Medicare Part D plan offerings - 87.1% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.4.
Real-world access to methadone hydrochloride 2 MG/ML Oral Solution depends on utilization management as much as tier placement: 44.3% of covering formularies require prior authorization. 0% require step therapy. 85.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 68,081 Part D beneficiaries filled methadone hydrochloride 2 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $13,167,959 and an average per-beneficiary annual cost of $193.42. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methadone hydrochloride 2 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 221
- Plans covering
- 4,402
- Coverage rate
- 87.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 44.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 85.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 68,081
- Total spending
- $13,167,959
- Avg per beneficiary
- $193.42
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methadone hydrochloride 2 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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| 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 |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methadone hydrochloride 2 MG/ML Oral Solution covered by Medicare Part D?
Yes, methadone hydrochloride 2 MG/ML Oral Solution is covered by 4,402 Medicare Part D plans (87.1% of all Part D formularies).
What tier is methadone hydrochloride 2 MG/ML Oral Solution on Medicare Part D plans?
methadone hydrochloride 2 MG/ML Oral Solution averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does methadone hydrochloride 2 MG/ML Oral Solution require prior authorization?
44.3% of Part D formularies require prior authorization for methadone hydrochloride 2 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 85.1%.
How much does Medicare spend on methadone hydrochloride 2 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on methadone hydrochloride 2 MG/ML Oral Solution was $13,167,959, covering 68,081 beneficiaries. The average spend per beneficiary was $193.42.
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
- acetaminophen 325 MG / oxycodone hydrochloride 7.5 MG Oral Tablet T2.4
- quinidine sulfate 300 MG Oral Tablet T2.4
- deferasirox 90 MG Oral Tablet T2.4
- dexmethylphenidate hydrochloride 10 MG Oral Tablet T2.4
- {12 (risedronate sodium 35 MG Oral Tablet) } Pack T2.4
- {4 (risedronate sodium 35 MG Oral Tablet) } Pack T2.4
Similar prior-authorization rate
- olanzapine 5 MG / samidorphan 10 MG Oral Tablet [Lybalvi] 44.1% PA
- clorazepate dipotassium 15 MG Oral Tablet 43.9% PA
- prednisolone 3 MG/ML Oral Solution 44.8% PA
- 24 HR pregabalin 165 MG Extended Release Oral Tablet 43.8% PA
- anidulafungin 100 MG Injection [Eraxis] 45% PA
- morphine sulfate 15 MG Extended Release Oral Tablet 45.1% PA