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PlainMedicare

Is phenylephrine hydrochloride / promethazine hydrochloride covered by Medicare Part D?

17 of 5,052 Medicare Part D plan offerings (0.3%) list phenylephrine hydrochloride / promethazine hydrochloride on their 2026 formulary, most often on tier 2; 84.6% of the formularies that cover it require prior authorization. Part D spending on it was $28 thousand in 2024 for at least 434 people: what plans and patients paid at the pharmacy, before manufacturer rebates (CMS Part D Spending by Drug).

Plans that cover it
0.3%
17 of 5,052 offerings; the median drug: 76%
Usual tier
Tier 2
from tier 1 to tier 4
Prior authorization
84.6%
of formularies that cover it; the median drug: 1%
Quantity limits
0%
of formularies that cover it; the median drug: 30%

Source: CMS Part D formulary file, 2026 second quarter: the formularies in use in 2026. A plan's 2027 formulary can differ; check your own plan's coverage in Medicare Plan Finder.

What does it cost under Part D in 2027?

Your yearly cap in 2027
Out-of-pocket spending on covered Part D drugs stops at $2,400 in 2027 ($2,100 in 2026); after that, you pay nothing for covered drugs for the rest of the year.
The deductible
A plan's drug deductible is at most $700 in 2027 ($615 in 2026); many plans charge less or none.

Source: CMS, Announcement of calendar year 2027 Part D parameters; Medicare.gov, “How much does Medicare drug coverage cost?” (read Oct. 7, 2026).

How much does Medicare spend on it?

Part D spending by year

2021$16 thousand
2022$48 thousand
2023$37 thousand
2024 (latest)$28 thousand

434 people filled it under Part D in 2024, in 627 claims. The amounts are what plans and patients paid at the pharmacy, before manufacturer rebates.

Source: CMS Medicare Part D Spending by Drug, 2020 to 2024 (published June 2026). Row used: Promethazine Vc (Phenylephrine HCl/Prometh HCl), Promethazine-Phenylephrine HCl (Phenylephrine HCl/Prometh HCl).

Which forms and strengths are counted?

  • phenylephrine hydrochloride 1 mg/ml / promethazine hydrochloride 1.25 mg/ml oral solution

What else should you check?

Data, not medical advice. Coverage is the share of plan formularies listing the drug; your plan's formulary, tier and pharmacy decide what you pay.