Medicare Part D coverage · methotrexate · RxCUI 284592
methotrexate 5 MG Oral Tablet [Trexall]
Per the CMS 2026 Part D formulary file, methotrexate 5 MG Oral Tablet [Trexall] is covered by 168 Medicare Part D plans (3.3% of enrollable products), averaging Tier 2.9, with prior authorization required on 25% of covering formularies.
- 3.3%
- Plan coverage
- 168
- Plans covering
- T2.9
- Avg tier
- 25%
- Prior auth required
What the CMS Formulary Data Shows for methotrexate 5 MG Oral Tablet [Trexall]
Per the CMS 2026 Part D formulary file, methotrexate 5 MG Oral Tablet [Trexall] (RxNorm concept RXCUI 284592, generic name methotrexate) appears on 12 distinct formulary files spanning 168 Medicare Part D plan offerings - 3.3% 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 2.9.
Real-world access to methotrexate 5 MG Oral Tablet [Trexall] depends on utilization management as much as tier placement: 25% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 84 Part D beneficiaries filled methotrexate 5 MG Oral Tablet [Trexall] in 2023, with total plan-and-beneficiary spending of $248,445 and an average per-beneficiary annual cost of $2,957.68. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methotrexate 5 MG Oral Tablet [Trexall] today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 168
- Coverage rate
- 3.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 25% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 84
- Total spending
- $248,445
- Avg per beneficiary
- $2,957.68
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methotrexate 5 MG Oral Tablet [Trexall]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methotrexate 5 MG Oral Tablet [Trexall] covered by Medicare Part D?
Yes, methotrexate 5 MG Oral Tablet [Trexall] is covered by 168 Medicare Part D plans (3.3% of all Part D formularies).
What tier is methotrexate 5 MG Oral Tablet [Trexall] on Medicare Part D plans?
methotrexate 5 MG Oral Tablet [Trexall] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does methotrexate 5 MG Oral Tablet [Trexall] require prior authorization?
25% of Part D formularies require prior authorization for methotrexate 5 MG Oral Tablet [Trexall]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on methotrexate 5 MG Oral Tablet [Trexall]?
In 2023, total Medicare Part D spending on methotrexate 5 MG Oral Tablet [Trexall] was $248,445, covering 84 beneficiaries. The average spend per beneficiary was $2,957.68.
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
- 0.3 ML enoxaparin sodium 100 MG/ML Prefilled Syringe T2.9
- 0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe T2.9
- 0.6 ML enoxaparin sodium 100 MG/ML Prefilled Syringe T2.9
- 0.8 ML enoxaparin sodium 100 MG/ML Prefilled Syringe T2.9
- 24 HR nevirapine 400 MG Extended Release Oral Tablet T2.9
- aztreonam 1000 MG Injection T2.9
Similar prior-authorization rate
- lorazepam 0.5 MG Oral Tablet 25% PA
- tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] 25% PA
- hydroxyurea 100 MG/ML Oral Solution [Xromi] 25% PA
- Modified 24 HR metformin hydrochloride 1000 MG Extended Release Oral Tablet 25% PA
- prednisolone 10 MG Disintegrating Oral Tablet [Orapred] 25% PA
- insulin lispro-aabc 100 UNT/ML Injectable Solution [Lyumjev] 25% PA