naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy]

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naloxone hydrochloride

RxCUI: 2680741

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
44.7%
Plan Coverage
2,263
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy]

Per the CMS 2026 Part D formulary file, naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] (RxNorm concept RXCUI 2680741, generic name naloxone hydrochloride) appears on 119 distinct formulary files spanning 2,263 Medicare Part D plan offerings - 44.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.

Real-world access to naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 2.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 744,446 Part D beneficiaries filled naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] in 2023, with total plan-and-beneficiary spending of $71,560,437 and an average per-beneficiary annual cost of $96.13. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] today.

Coverage Details

Formularies covering
119
Plans covering
2,263
Coverage rate
44.7%
Tier range
Tier 1 – Tier 6
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
2.5% of formularies

2023 Medicare Spending

Beneficiaries
744,446
Total spending
$71,560,437
Avg per beneficiary
$96.13

Tier Distribution Across Plans

92 plans
Tier 1, Preferred Generic
8 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
KeyCare Advantage Plus (HMO C-SNP) ISNP VENTURES, LLC T1 No $0 MD
Premier Care (HMO-POS I-SNP) LIFEWORKS ADVANTAGE, LLC T1 No $0 VA
Premier Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $0 CA
Advantage Care (HMO) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $0 CA
Premier Care (HMO-POS I-SNP) ALIGN SENIOR CARE MI, LLC T1 No $0 MI
Premier Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $0 FL
Perennial Advantage Freedom (HMO-POS) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 CO
Perennial Advantage Premier (HMO-POS I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 CO
Perennial Advantage Freedom (HMO) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 PA
Perennial Advantage Premier (HMO I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 PA
Perennial Advantage Freedom (HMO-POS) PERENNIAL ADVANTAGE OF OHIO, INC. T1 No $0 OH
Perennial Advantage Premier (HMO-POS I-SNP) PERENNIAL ADVANTAGE OF OHIO, INC. T1 No $0 OH
ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $0 TX
PruittHealth Premier Advantage (HMO I-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Senior Health Plan Silver Plus (HMO) COMMUNITYCARE GOVERNMENT PROGRAMS, INC. T1 No $0 OK
Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) COMMUNITYCARE GOVERNMENT PROGRAMS, INC. T1 No $0 OK
Community First Medicare Advantage Alamo Plan (HMO) COMMUNITY FIRST HEALTH PLANS, INC. T1 No $0 TX
Community First Medicare Advantage D-SNP (HMO D-SNP) COMMUNITY FIRST HEALTH PLANS, INC. T1 No $0 TX
Community DualCare Aligned (HMO D-SNP) COMMUNITY HEALTH CHOICE TEXAS, INC. T1 No $0 TX
Community DualCare Access (HMO D-SNP) COMMUNITY HEALTH CHOICE TEXAS, INC. T1 No $0 TX
El Paso Health Medicare Advantage Dual (HMO D-SNP) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
El Paso Health Total (HMO) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
El Paso Health Giveback (HMO) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
Liberty Medicare Advantage (HMO C-SNP) LIBERTY ADVANTAGE, LLC T1 No $0 NC
Peak Advantage Vista (PPO) PEAK HEALTH INSURANCE CORPORATION T1 No $0 PA, WV
SECUR Edge (HMO I-SNP) SECUR INC T1 No $0 FL
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 No $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
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
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
Senior Care (HMO I-SNP) NHC ADVANTAGE, LLC T1 No $0 MO, NC, SC, TN
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 No $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 No $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK

Frequently Asked Questions

Is naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] covered by Medicare Part D?

Yes, naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] is covered by 2,263 Medicare Part D plans (44.7% of all Part D formularies).

What tier is naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] on Medicare Part D plans?

naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 6.

Does naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] require prior authorization?

0% of Part D formularies require prior authorization for naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy]. Step therapy: 0%. Quantity limits: 2.5%.

How much does Medicare spend on naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy]?

In 2023, total Medicare Part D spending on naloxone hydrochloride 16 MG/ML Nasal Spray [Rextovy] was $71,560,437, covering 744,446 beneficiaries. The average spend per beneficiary was $96.13.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial