Medicare Part D coverage · nifedipine · RxCUI 198033
nifedipine 20 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nifedipine 20 MG Oral Capsule is covered by 573 Medicare Part D plans (11.3% of enrollable products), averaging Tier 1.7, with prior authorization required on 23.3% of covering formularies.
- 11.3%
- Plan coverage
- 573
- Plans covering
- T1.7
- Avg tier
- 23.3%
- Prior auth required
What the CMS Formulary Data Shows for nifedipine 20 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nifedipine 20 MG Oral Capsule (RxNorm concept RXCUI 198033, generic name nifedipine) appears on 60 distinct formulary files spanning 573 Medicare Part D plan offerings - 11.3% 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 1.7.
Real-world access to nifedipine 20 MG Oral Capsule depends on utilization management as much as tier placement: 23.3% 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 849,024 Part D beneficiaries filled nifedipine 20 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $146,639,349 and an average per-beneficiary annual cost of $172.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nifedipine 20 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 60
- Plans covering
- 573
- Coverage rate
- 11.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 23.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 849,024
- Total spending
- $146,639,349
- Avg per beneficiary
- $172.72
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nifedipine 20 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| 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 |
Show the next 30 plans
| 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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $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 |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Senior Care (HMO I-SNP) | NHC Advantage, LLC | T1 | No | $0 | MO, NC, SC, TN |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is nifedipine 20 MG Oral Capsule covered by Medicare Part D?
Yes, nifedipine 20 MG Oral Capsule is covered by 573 Medicare Part D plans (11.3% of all Part D formularies).
What tier is nifedipine 20 MG Oral Capsule on Medicare Part D plans?
nifedipine 20 MG Oral Capsule averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does nifedipine 20 MG Oral Capsule require prior authorization?
23.3% of Part D formularies require prior authorization for nifedipine 20 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on nifedipine 20 MG Oral Capsule?
In 2023, total Medicare Part D spending on nifedipine 20 MG Oral Capsule was $146,639,349, covering 849,024 beneficiaries. The average spend per beneficiary was $172.72.
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
- triazolam 0.125 MG Oral Tablet 23.3% PA
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- 24 HR guanfacine 1 MG Extended Release Oral Tablet 23.1% PA
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