Medicare Part D coverage · methotrexate · RxCUI 105585
methotrexate 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, methotrexate 2.5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.7, with prior authorization required on 27.1% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.7
- Avg tier
- 27.1%
- Prior auth required
What the CMS Formulary Data Shows for methotrexate 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, methotrexate 2.5 MG Oral Tablet (RxNorm concept RXCUI 105585, generic name methotrexate) 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 4, with a cross-plan average of Tier 1.7.
Real-world access to methotrexate 2.5 MG Oral Tablet depends on utilization management as much as tier placement: 27.1% of covering formularies require prior authorization. 15.9% 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 Oral Tablet 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 Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 27.1% of formularies
- Step therapy required
- 15.9% 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 Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methotrexate 2.5 MG Oral Tablet covered by Medicare Part D?
Yes, methotrexate 2.5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is methotrexate 2.5 MG Oral Tablet on Medicare Part D plans?
methotrexate 2.5 MG Oral Tablet averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does methotrexate 2.5 MG Oral Tablet require prior authorization?
27.1% of Part D formularies require prior authorization for methotrexate 2.5 MG Oral Tablet. Step therapy: 15.9%. Quantity limits: 0%.
How much does Medicare spend on methotrexate 2.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on methotrexate 2.5 MG Oral Tablet 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
Similar prior-authorization rate
- lisdexamfetamine dimesylate 40 MG Chewable Tablet 27.1% PA
- midazolam 50 MG/ML Nasal Spray [Nayzilam] 27.1% PA
- aspirin 325 MG / butalbital 50 MG / caffeine 40 MG Oral Capsule 27.2% PA
- guanfacine 1 MG Oral Tablet 27% PA
- 1 ML heparin sodium, porcine 10000 UNT/ML Injection 27% PA
- 24 HR donepezil hydrochloride 10 MG / memantine hydrochloride 28 MG Extended Release Oral Capsule 27.3% PA