Medicare Part D coverage · nitrofurantoin, · RxCUI 311994
nitrofurantoin, macrocrystals 25 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nitrofurantoin, macrocrystals 25 MG Oral Capsule is covered by 1,253 Medicare Part D plans (24.8% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.
- 24.8%
- Plan coverage
- 1,253
- Plans covering
- T2.4
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for nitrofurantoin, macrocrystals 25 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nitrofurantoin, macrocrystals 25 MG Oral Capsule (RxNorm concept RXCUI 311994, generic name nitrofurantoin,) appears on 58 distinct formulary files spanning 1,253 Medicare Part D plan offerings - 24.8% 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 2.4.
Real-world access to nitrofurantoin, macrocrystals 25 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 19% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,638,012 Part D beneficiaries filled nitrofurantoin, macrocrystals 25 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $76,395,047 and an average per-beneficiary annual cost of $28.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nitrofurantoin, macrocrystals 25 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 58
- Plans covering
- 1,253
- Coverage rate
- 24.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 19% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,638,012
- Total spending
- $76,395,047
- Avg per beneficiary
- $28.96
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nitrofurantoin, macrocrystals 25 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| DrMax (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect-CFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrElite-SFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| 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 |
| 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 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
Show the next 30 plans
| 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 |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| CareOregon Advantage Plus (HMO D-SNP) | Health Plan OF Careoregon, Inc. | T1 | No | $0 | OR |
| 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 |
| DrFlex (HMO D-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $1.10 | FL |
| DrPlus (HMO D-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $4.80 | FL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is nitrofurantoin, macrocrystals 25 MG Oral Capsule covered by Medicare Part D?
Yes, nitrofurantoin, macrocrystals 25 MG Oral Capsule is covered by 1,253 Medicare Part D plans (24.8% of all Part D formularies).
What tier is nitrofurantoin, macrocrystals 25 MG Oral Capsule on Medicare Part D plans?
nitrofurantoin, macrocrystals 25 MG Oral Capsule averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does nitrofurantoin, macrocrystals 25 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for nitrofurantoin, macrocrystals 25 MG Oral Capsule. Step therapy: 0%. Quantity limits: 19%.
How much does Medicare spend on nitrofurantoin, macrocrystals 25 MG Oral Capsule?
In 2023, total Medicare Part D spending on nitrofurantoin, macrocrystals 25 MG Oral Capsule was $76,395,047, covering 2,638,012 beneficiaries. The average spend per beneficiary was $28.96.
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
- acetaminophen 325 MG / oxycodone hydrochloride 10 MG Oral Tablet T2.4
- prednisolone acetate 10 MG/ML Ophthalmic Suspension T2.4
- repaglinide 2 MG Oral Tablet T2.4
- rivastigmine 1.5 MG Oral Capsule T2.4
- acetylcysteine 200 MG/ML Inhalation Solution T2.4
- 12 HR diltiazem hydrochloride 60 MG Extended Release Oral Capsule T2.4
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA