Medicare Part D coverage · paroxetine hydrochloride · RxCUI 1738495
paroxetine hydrochloride 20 MG Oral Tablet
Per the CMS 2026 Part D formulary file, paroxetine hydrochloride 20 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.6, with prior authorization required on 32% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.6
- Avg tier
- 32%
- Prior auth required
What the CMS Formulary Data Shows for paroxetine hydrochloride 20 MG Oral Tablet
Per the CMS 2026 Part D formulary file, paroxetine hydrochloride 20 MG Oral Tablet (RxNorm concept RXCUI 1738495, generic name paroxetine hydrochloride) 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 6, with a cross-plan average of Tier 1.6.
Real-world access to paroxetine hydrochloride 20 MG Oral Tablet depends on utilization management as much as tier placement: 32% of covering formularies require prior authorization. 0% require step therapy. 35.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 697,107 Part D beneficiaries filled paroxetine hydrochloride 20 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $51,468,785 and an average per-beneficiary annual cost of $73.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry paroxetine hydrochloride 20 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 32% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 35.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 697,107
- Total spending
- $51,468,785
- Avg per beneficiary
- $73.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering paroxetine hydrochloride 20 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
Show the next 30 plans
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T1 | Yes | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IA |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | NE |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Advantra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | SD |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Dual Extra (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is paroxetine hydrochloride 20 MG Oral Tablet covered by Medicare Part D?
Yes, paroxetine hydrochloride 20 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is paroxetine hydrochloride 20 MG Oral Tablet on Medicare Part D plans?
paroxetine hydrochloride 20 MG Oral Tablet averages Tier 1.6 across Part D plans, ranging from Tier 1 to Tier 6.
Does paroxetine hydrochloride 20 MG Oral Tablet require prior authorization?
32% of Part D formularies require prior authorization for paroxetine hydrochloride 20 MG Oral Tablet. Step therapy: 0%. Quantity limits: 35.1%.
How much does Medicare spend on paroxetine hydrochloride 20 MG Oral Tablet?
In 2023, total Medicare Part D spending on paroxetine hydrochloride 20 MG Oral Tablet was $51,468,785, covering 697,107 beneficiaries. The average spend per beneficiary was $73.83.
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
- atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet 31.9% PA
- hydroxyzine pamoate 100 MG Oral Capsule 32.1% PA
- {14 (cenobamate 100 MG Oral Tablet [Xcopri]) / 14 (cenobamate 50 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 50 MG (14), 100 MG (14) 28 Count] 32.3% PA
- {28 (cenobamate 150 MG Oral Tablet [Xcopri]) / 28 (cenobamate 200 MG Oral Tablet) } Pack [Xcopri 350 MG Maintenance Pack] 32.3% PA
- cenobamate 50 MG Oral Tablet [Xcopri] 32.3% PA
- cenobamate 25 MG Oral Tablet [Xcopri] 32.3% PA