oxybutynin chloride 1 MG/ML Oral Solution

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oxybutynin chloride

RxCUI: 863599

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.
98.5%
Plan Coverage
4,992
Plans Covering
T2
Avg Tier
0.6%
Prior Auth Required

What the CMS Formulary Data Shows for oxybutynin chloride 1 MG/ML Oral Solution

Per the CMS 2026 Part D formulary file, oxybutynin chloride 1 MG/ML Oral Solution (RxNorm concept RXCUI 863599, generic name oxybutynin chloride) appears on 317 distinct formulary files spanning 4,992 Medicare Part D plan offerings - 98.5% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.

Real-world access to oxybutynin chloride 1 MG/ML Oral Solution depends on utilization management as much as tier placement: 0.6% of covering formularies require prior authorization. 0% require step therapy. 48.9% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 881,680 Part D beneficiaries filled oxybutynin chloride 1 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $113,070,736 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 1 MG/ML Oral Solution today.

Coverage Details

Formularies covering
317
Plans covering
4,992
Coverage rate
98.5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0.6% of formularies
Step therapy required
0% of formularies
Quantity limits
48.9% of formularies

2023 Medicare Spending

Beneficiaries
881,680
Total spending
$113,070,736
Avg per beneficiary
$128.24

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering oxybutynin chloride 1 MG/ML Oral Solution

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

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
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
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL

Frequently Asked Questions

Is oxybutynin chloride 1 MG/ML Oral Solution covered by Medicare Part D?

Yes, oxybutynin chloride 1 MG/ML Oral Solution is covered by 4,992 Medicare Part D plans (98.5% of all Part D formularies).

What tier is oxybutynin chloride 1 MG/ML Oral Solution on Medicare Part D plans?

oxybutynin chloride 1 MG/ML Oral Solution averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.

Does oxybutynin chloride 1 MG/ML Oral Solution require prior authorization?

0.6% of Part D formularies require prior authorization for oxybutynin chloride 1 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 48.9%.

How much does Medicare spend on oxybutynin chloride 1 MG/ML Oral Solution?

In 2023, total Medicare Part D spending on oxybutynin chloride 1 MG/ML Oral Solution was $113,070,736, covering 881,680 beneficiaries. The average spend per beneficiary was $128.24.

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