Medicare Part D coverage · phenoxybenzamine hydrochloride · RxCUI 861402

phenoxybenzamine hydrochloride 10 MG Oral Capsule

Per the CMS 2026 Part D formulary file, phenoxybenzamine hydrochloride 10 MG Oral Capsule is covered by 654 Medicare Part D plans (12.9% of enrollable products), averaging Tier 4.5, with prior authorization required on 26.7% of covering formularies.

12.9%
Plan coverage
654
Plans covering
T4.5
Avg tier
26.7%
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 phenoxybenzamine hydrochloride 10 MG Oral Capsule

Per the CMS 2026 Part D formulary file, phenoxybenzamine hydrochloride 10 MG Oral Capsule (RxNorm concept RXCUI 861402, generic name phenoxybenzamine hydrochloride) appears on 75 distinct formulary files spanning 654 Medicare Part D plan offerings - 12.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.5.

Real-world access to phenoxybenzamine hydrochloride 10 MG Oral Capsule depends on utilization management as much as tier placement: 26.7% of covering formularies require prior authorization. 0% require step therapy. 2.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 157 Part D beneficiaries filled phenoxybenzamine hydrochloride 10 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $4,343,640 and an average per-beneficiary annual cost of $27,666.50. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry phenoxybenzamine hydrochloride 10 MG Oral Capsule today.

Coverage Details

Formularies covering
75
Plans covering
654
Coverage rate
12.9%
Tier range
Tier 1 – Tier 5
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
26.7% of formularies
Step therapy required
0% of formularies
Quantity limits
2.7% of formularies

2023 Medicare Spending

Beneficiaries
157
Total spending
$4,343,640
Avg per beneficiary
$27,666.50

Tier Distribution Across Plans

13 plans
Tier 1, Preferred Generic
4 plans
Tier 2, Generic
8 plans
Tier 4, Non-Preferred
75 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering phenoxybenzamine hydrochloride 10 MG Oral Capsule

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

Plan Insurer Tier PA Premium States
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
Horizon NJ TotalCare (HMO D-SNP) Horizon Healthcare OF NEW Jersey, Inc. T1 No $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
AbilityCare (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) Alameda Alliance FOR Health T1 Yes $0 CA
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Hcsc Insurance Services Company T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS Insurance Company T1 No $5.00 OK
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 No $34.50 NY
Aspire Health Protect (HMO) Aspire Health Plan T2 No $0 CA
Aspire Health Value (HMO) Aspire Health Plan T2 No $22.60 CA
Aspire Health Advantage (HMO) Aspire Health Plan T2 No $44.80 CA
Aspire Health Plus (HMO-POS) Aspire Health Plan T2 No $119.20 CA
Geisinger Gold Preferred Complete Rx (PPO) Geisinger Indemnity Insurance Company T4 Yes $0 PA
Geisinger Gold Secure Rx (HMO D-SNP) Geisinger Health Plan T4 Yes $0 PA
Geisinger Gold Classic 360 Rx (HMO) Geisinger Health Plan T4 Yes $0 PA
Show the next 30 plans
Geisinger Gold Classic Essential Rx (HMO) Geisinger Health Plan T4 Yes $0 PA
Geisinger Gold Value Rx (HMO) Geisinger Health Plan T4 Yes $23.00 PA
Geisinger Gold Classic Complete Rx (HMO) Geisinger Health Plan T4 Yes $48.00 PA
Geisinger Gold Classic Advantage Rx (HMO) Geisinger Health Plan T4 Yes $99.30 PA
Geisinger Gold Preferred Advantage Rx (PPO) Geisinger Indemnity Insurance Company T4 Yes $112.00 PA
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Flex (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Active (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare Wellness (HMO) Selecthealth, Inc. T5 Yes $0 NV
Medicare BlueEssential (PPO) Excellus Health Plan, Inc. T5 No $0 NY
Medicare BlueActive (PPO) Excellus Health Plan, Inc. T5 No $0 NY
Medicare BlueVital (PPO) Excellus Health Plan, Inc. T5 No $0 NY
Univera SeniorChoice Basic (HMO) Excellus Health Plan, Inc. T5 No $0 NY
Univera SeniorChoice Extra (HMO) Excellus Health Plan, Inc. T5 No $0 NY
Medicare Blue Choice Core (HMO) Excellus Health Plan, Inc. T5 No $0 NY
Univera Medicare Dual (HMO D-SNP) Excellus Health Plan Community Care LLC T5 No $0 NY
Medicare Blue Dual (HMO D-SNP) Excellus Health Plan Community Care LLC T5 No $0 NY
HealthSpring Preferred (HMO) Bravo Health Pennsylvania, Inc. T5 No $0 AZ
HealthSpring Alliance (HMO) Bravo Health Pennsylvania, Inc. T5 No $0 AZ
HealthSpring Preferred Savings (HMO) Bravo Health Pennsylvania, Inc. T5 No $0 AZ

Showing top 50 of 100 plans.

Frequently Asked Questions

Is phenoxybenzamine hydrochloride 10 MG Oral Capsule covered by Medicare Part D?

Yes, phenoxybenzamine hydrochloride 10 MG Oral Capsule is covered by 654 Medicare Part D plans (12.9% of all Part D formularies).

What tier is phenoxybenzamine hydrochloride 10 MG Oral Capsule on Medicare Part D plans?

phenoxybenzamine hydrochloride 10 MG Oral Capsule averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.

Does phenoxybenzamine hydrochloride 10 MG Oral Capsule require prior authorization?

26.7% of Part D formularies require prior authorization for phenoxybenzamine hydrochloride 10 MG Oral Capsule. Step therapy: 0%. Quantity limits: 2.7%.

How much does Medicare spend on phenoxybenzamine hydrochloride 10 MG Oral Capsule?

In 2023, total Medicare Part D spending on phenoxybenzamine hydrochloride 10 MG Oral Capsule was $4,343,640, covering 157 beneficiaries. The average spend per beneficiary was $27,666.50.

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