Medicare Part D coverage · methotrexate · RxCUI 1921598
methotrexate 2.5 MG/ML Oral Solution [Xatmep]
Per the CMS 2026 Part D formulary file, methotrexate 2.5 MG/ML Oral Solution [Xatmep] is covered by 4,818 Medicare Part D plans (95.4% of enrollable products), averaging Tier 3.4, with prior authorization required on 83.4% of covering formularies.
- 95.4%
- Plan coverage
- 4,818
- Plans covering
- T3.4
- Avg tier
- 83.4%
- Prior auth required
What the CMS Formulary Data Shows for methotrexate 2.5 MG/ML Oral Solution [Xatmep]
Per the CMS 2026 Part D formulary file, methotrexate 2.5 MG/ML Oral Solution [Xatmep] (RxNorm concept RXCUI 1921598, generic name methotrexate) appears on 295 distinct formulary files spanning 4,818 Medicare Part D plan offerings - 95.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.4.
Real-world access to methotrexate 2.5 MG/ML Oral Solution [Xatmep] depends on utilization management as much as tier placement: 83.4% of covering formularies require prior authorization. 21% 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 2.5 MG/ML Oral Solution [Xatmep] 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 2.5 MG/ML Oral Solution [Xatmep] today.
Coverage Details
- Formularies covering
- 295
- Plans covering
- 4,818
- Coverage rate
- 95.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 83.4% of formularies
- Step therapy required
- 21% 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 2.5 MG/ML Oral Solution [Xatmep]
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 |
| 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 |
| 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 |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
Show the next 30 plans
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| 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 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methotrexate 2.5 MG/ML Oral Solution [Xatmep] covered by Medicare Part D?
Yes, methotrexate 2.5 MG/ML Oral Solution [Xatmep] is covered by 4,818 Medicare Part D plans (95.4% of all Part D formularies).
What tier is methotrexate 2.5 MG/ML Oral Solution [Xatmep] on Medicare Part D plans?
methotrexate 2.5 MG/ML Oral Solution [Xatmep] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does methotrexate 2.5 MG/ML Oral Solution [Xatmep] require prior authorization?
83.4% of Part D formularies require prior authorization for methotrexate 2.5 MG/ML Oral Solution [Xatmep]. Step therapy: 21%. Quantity limits: 0%.
How much does Medicare spend on methotrexate 2.5 MG/ML Oral Solution [Xatmep]?
In 2023, total Medicare Part D spending on methotrexate 2.5 MG/ML Oral Solution [Xatmep] 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
- {14 (cenobamate 12.5 MG Oral Tablet [Xcopri]) / 14 (cenobamate 25 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 12.5 MG (14), 25 MG (14) 28 Count] T3.4
- {2 (iloperidone 1 MG Oral Tablet [Fanapt]) / 2 (iloperidone 2 MG Oral Tablet [Fanapt]) / 2 (iloperidone 4 MG Oral Tablet [Fanapt]) / 2 (iloperidone 6 MG Oral Tablet [Fanapt]) } Pack [Fanapt Titration Pack] T3.4
- Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma] T3.4
- Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma] T3.4
- fluticasone propionate 0.093 MG/ACTUAT Metered Dose Nasal Spray [Xhance] T3.4
- 0.4 ML darbepoetin alfa 0.1 MG/ML Prefilled Syringe [Aranesp] T3.4
Similar prior-authorization rate
- 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] 83.3% PA
- sofosbuvir 400 MG Oral Tablet [Sovaldi] 83.3% PA
- American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] 83.3% PA
- estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] 83.3% PA
- triheptanoin 1000 MG/ML Oral Solution [Dojolvi] 83.3% PA
- 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard] 83.2% PA