Medicare Part D coverage · oxybutynin chloride · RxCUI 863664
oxybutynin chloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, oxybutynin chloride 5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.8, with prior authorization required on 2.1% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.8
- Avg tier
- 2.1%
- Prior auth required
What the CMS Formulary Data Shows for oxybutynin chloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, oxybutynin chloride 5 MG Oral Tablet (RxNorm concept RXCUI 863664, generic name oxybutynin chloride) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.8.
Real-world access to oxybutynin chloride 5 MG Oral Tablet depends on utilization management as much as tier placement: 2.1% of covering formularies require prior authorization. 0% require step therapy. 38.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 881,680 Part D beneficiaries filled oxybutynin chloride 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $113,070,439 and an average per-beneficiary annual cost of $128.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry oxybutynin chloride 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 2.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 38.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 881,680
- Total spending
- $113,070,439
- Avg per beneficiary
- $128.24
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering oxybutynin chloride 5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is oxybutynin chloride 5 MG Oral Tablet covered by Medicare Part D?
Yes, oxybutynin chloride 5 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is oxybutynin chloride 5 MG Oral Tablet on Medicare Part D plans?
oxybutynin chloride 5 MG Oral Tablet averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does oxybutynin chloride 5 MG Oral Tablet require prior authorization?
2.1% of Part D formularies require prior authorization for oxybutynin chloride 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 38.7%.
How much does Medicare spend on oxybutynin chloride 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on oxybutynin chloride 5 MG Oral Tablet was $113,070,439, covering 881,680 beneficiaries. The average spend per beneficiary was $128.24.
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
- 2 ML methotrexate 25 MG/ML Injection T1.8
- 24 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet T1.8
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- ketorolac tromethamine 5 MG/ML Ophthalmic Solution T1.8
- lidocaine hydrochloride 20 MG/ML Mucous Membrane Topical Solution T1.8
- mirtazapine 7.5 MG Oral Tablet T1.8