Medicare Part D coverage · omadacycline · RxCUI 2059280

omadacycline 150 MG Oral Tablet [Nuzyra]

Per the CMS 2026 Part D formulary file, omadacycline 150 MG Oral Tablet [Nuzyra] is covered by 2,757 Medicare Part D plans (54.6% of enrollable products), averaging Tier 4.4, with prior authorization required on 7.9% of covering formularies.

54.6%
Plan coverage
2,757
Plans covering
T4.4
Avg tier
7.9%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for omadacycline 150 MG Oral Tablet [Nuzyra]

Per the CMS 2026 Part D formulary file, omadacycline 150 MG Oral Tablet [Nuzyra] (RxNorm concept RXCUI 2059280, generic name omadacycline) appears on 89 distinct formulary files spanning 2,757 Medicare Part D plan offerings - 54.6% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.4.

Real-world access to omadacycline 150 MG Oral Tablet [Nuzyra] depends on utilization management as much as tier placement: 7.9% of covering formularies require prior authorization. 0% require step therapy. 68.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,687 Part D beneficiaries filled omadacycline 150 MG Oral Tablet [Nuzyra] in 2023, with total plan-and-beneficiary spending of $73,196,529 and an average per-beneficiary annual cost of $19,852.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry omadacycline 150 MG Oral Tablet [Nuzyra] today.

Coverage Details

Formularies covering
89
Plans covering
2,757
Coverage rate
54.6%
Tier range
Tier 1 – Tier 6
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
7.9% of formularies
Step therapy required
0% of formularies
Quantity limits
68.5% of formularies

2023 Medicare Spending

Beneficiaries
3,687
Total spending
$73,196,529
Avg per beneficiary
$19,852.60

Tier Distribution Across Plans

24 plans
Tier 1, Preferred Generic
54 plans
Tier 4, Non-Preferred
22 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering omadacycline 150 MG Oral Tablet [Nuzyra]

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Preferred from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -

Medicare Advantage Plans (MA-PD) Covering omadacycline 150 MG Oral Tablet [Nuzyra]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 No $0 FL
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) Health Choice Arizona, Inc. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 No $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 No $0 NY
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
CCA One Care (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
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
Florida Complete Care (HMO I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 No $22.70 NY
Show the next 30 plans
VIVA Medicare Extra Value (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) Elderplan, Inc. T1 No $44.80 NY
MetroPlus Platinum Plan (HMO) Metroplus Health Plan, Inc. T1 No $58.80 NY
Select Health Medicare Essential (HMO) Selecthealth, Inc. T4 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T4 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T4 No $0 UT
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T4 No $0 NV
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T4 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare Essential (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare Flex (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare Active (HMO) Selecthealth, Inc. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T4 No $0 NV
Select Health Medicare Wellness (HMO) Selecthealth, Inc. T4 No $0 NV
Freedom VIP Care (HMO C-SNP) Freedom Health, Inc. T4 No $0 FL
Freedom VIP Savings (HMO C-SNP) Freedom Health, Inc. T4 No $0 FL
Freedom VIP Savings (HMO C-SNP) Freedom Health, Inc. T4 No $0 FL
Freedom VIP Rewards (HMO C-SNP) Freedom Health, Inc. T4 No $0 FL
Freedom VIP Rewards (HMO C-SNP) Freedom Health, Inc. T4 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) Optimum Healthcare, Inc. T4 No $0 FL
Optimum Diamond Savings (HMO C-SNP) Optimum Healthcare, Inc. T4 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) Optimum Healthcare, Inc. T4 No $0 FL
Optimum Diamond (HMO C-SNP) Optimum Healthcare, Inc. T4 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) Freedom Health, Inc. T4 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) Freedom Health, Inc. T4 No $0 FL
Optimum Emerald Partial (HMO D-SNP) Optimum Healthcare, Inc. T4 No $0 FL

Showing top 50 of 95 plans.

Frequently Asked Questions

Is omadacycline 150 MG Oral Tablet [Nuzyra] covered by Medicare Part D?

Yes, omadacycline 150 MG Oral Tablet [Nuzyra] is covered by 2,757 Medicare Part D plans (54.6% of all Part D formularies).

What tier is omadacycline 150 MG Oral Tablet [Nuzyra] on Medicare Part D plans?

omadacycline 150 MG Oral Tablet [Nuzyra] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 6.

Does omadacycline 150 MG Oral Tablet [Nuzyra] require prior authorization?

7.9% of Part D formularies require prior authorization for omadacycline 150 MG Oral Tablet [Nuzyra]. Step therapy: 0%. Quantity limits: 68.5%.

How much does Medicare spend on omadacycline 150 MG Oral Tablet [Nuzyra]?

In 2023, total Medicare Part D spending on omadacycline 150 MG Oral Tablet [Nuzyra] was $73,196,529, covering 3,687 beneficiaries. The average spend per beneficiary was $19,852.60.

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.

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