phenoxybenzamine hydrochloride 10 MG Oral Capsule

Verify with CMS →

phenoxybenzamine hydrochloride

RxCUI: 861402

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.
12.9%
Plan Coverage
655
Plans Covering
T4.5
Avg Tier
26.7%
Prior Auth Required

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 655 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 $4,461,275 and an average per-beneficiary annual cost of $28,415.77. 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
655
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
$4,461,275
Avg per beneficiary
$28,415.77

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
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

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 655 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 $4,461,275, covering 157 beneficiaries. The average spend per beneficiary was $28,415.77.

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