naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet
naproxen sodium
RxCUI: 849450
What the CMS Formulary Data Shows for naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet
Per the CMS 2026 Part D formulary file, naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet (RxNorm concept RXCUI 849450, generic name naproxen sodium) appears on 11 distinct formulary files spanning 59 Medicare Part D plan offerings - 1.2% 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 3.
Real-world access to naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 39,316 Part D beneficiaries filled naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $5,373,172 and an average per-beneficiary annual cost of $136.67. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 59
- Coverage rate
- 1.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 39,316
- Total spending
- $5,373,172
- Avg per beneficiary
- $136.67
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet
57 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T1 | No | $51.60 | NY |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| SummaCare Medicare Topaz (HMO) | SUMMACARE INC. | T4 | No | $0 | OH |
| SummaCare Medicare Quartz (HMO) | SUMMACARE INC. | T4 | No | $0 | OH |
| VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) | VILLAGE SENIOR SERVICES CORPORATION | T4 | No | $0 | NY |
| VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) | VILLAGE SENIOR SERVICES CORPORATION | T4 | No | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| SummaCare Medicare Garnet (HMO) | SUMMACARE INC. | T4 | No | $35.00 | OH |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $47.00 | PA |
| SummaCare Medicare Ruby (HMO) | SUMMACARE INC. | T4 | No | $50.00 | OH |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $51.80 | PA |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $63.50 | PA |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $70.30 | NY |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $79.70 | PA |
| SummaCare Medicare Sapphire (HMO-POS) | SUMMACARE INC. | T4 | No | $83.00 | OH |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $86.40 | NY |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $98.20 | PA |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $100.00 | NY |
| SummaCare Medicare Emerald (HMO-POS) | SUMMACARE INC. | T4 | No | $100.80 | OH |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $102.20 | PA |
Frequently Asked Questions
Is naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet covered by Medicare Part D?
Yes, naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet is covered by 59 Medicare Part D plans (1.2% of all Part D formularies).
What tier is naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet on Medicare Part D plans?
naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet?
In 2023, total Medicare Part D spending on naproxen sodium 500 MG / sumatriptan 85 MG Oral Tablet was $5,373,172, covering 39,316 beneficiaries. The average spend per beneficiary was $136.67.
Read our methodology - how this data is sourced, computed, and verified.