Medicare Part D coverage · phenytoin · RxCUI 1313887

phenytoin 50 MG Chewable Tablet [Dilantin]

Per the CMS 2026 Part D formulary file, phenytoin 50 MG Chewable Tablet [Dilantin] is covered by 2,146 Medicare Part D plans (42.5% of enrollable products), averaging Tier 3.4, with prior authorization required on 4.4% of covering formularies.

42.5%
Plan coverage
2,146
Plans covering
T3.4
Avg tier
4.4%
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 phenytoin 50 MG Chewable Tablet [Dilantin]

Per the CMS 2026 Part D formulary file, phenytoin 50 MG Chewable Tablet [Dilantin] (RxNorm concept RXCUI 1313887, generic name phenytoin) appears on 45 distinct formulary files spanning 2,146 Medicare Part D plan offerings - 42.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.4.

Real-world access to phenytoin 50 MG Chewable Tablet [Dilantin] depends on utilization management as much as tier placement: 4.4% of covering formularies require prior authorization. 0% require step therapy. 4.4% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 14,557 Part D beneficiaries filled phenytoin 50 MG Chewable Tablet [Dilantin] in 2023, with total plan-and-beneficiary spending of $4,008,684 and an average per-beneficiary annual cost of $275.38. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry phenytoin 50 MG Chewable Tablet [Dilantin] today.

Coverage Details

Formularies covering
45
Plans covering
2,146
Coverage rate
42.5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
4.4% of formularies
Step therapy required
0% of formularies
Quantity limits
4.4% of formularies

2023 Medicare Spending

Beneficiaries
14,557
Total spending
$4,008,684
Avg per beneficiary
$275.38

Tier Distribution Across Plans

6 plans
Tier 1, Preferred Generic
94 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering phenytoin 50 MG Chewable Tablet [Dilantin]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 No $0 NY
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 No $0 CA
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
CareOregon Advantage Plus (HMO D-SNP) Health Plan OF Careoregon, Inc. T1 No $0 OR
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 No $34.50 NY
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Show the next 30 plans
Kaiser Permanente Senior Advantage Santa Cruz (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) Kaiser Foundation HP, Inc. T2 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) Kaiser Foundation HP OF Co T2 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Dual Complete (HMO D-SNP) Kaiser Foundation HP OF GA, Inc. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic (HMO) Kaiser Foundation HP, Inc. T2 No $0 HI
Kaiser Permanente Medicare Advantage Value 1 VA (HMO-POS) Kaiser Fdtn Hlth Plan OF THE Mid-atlantic States T2 No $0 VA
Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP) Kaiser Fdtn Hlth Plan OF THE Mid-atlantic States T2 No $0 MD
Kaiser Permanente Dual Complete Plan 2 MD (HMO D-SNP) Kaiser Fdtn Hlth Plan OF THE Mid-atlantic States T2 No $0 MD

Showing top 50 of 100 plans.

Frequently Asked Questions

Is phenytoin 50 MG Chewable Tablet [Dilantin] covered by Medicare Part D?

Yes, phenytoin 50 MG Chewable Tablet [Dilantin] is covered by 2,146 Medicare Part D plans (42.5% of all Part D formularies).

What tier is phenytoin 50 MG Chewable Tablet [Dilantin] on Medicare Part D plans?

phenytoin 50 MG Chewable Tablet [Dilantin] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does phenytoin 50 MG Chewable Tablet [Dilantin] require prior authorization?

4.4% of Part D formularies require prior authorization for phenytoin 50 MG Chewable Tablet [Dilantin]. Step therapy: 0%. Quantity limits: 4.4%.

How much does Medicare spend on phenytoin 50 MG Chewable Tablet [Dilantin]?

In 2023, total Medicare Part D spending on phenytoin 50 MG Chewable Tablet [Dilantin] was $4,008,684, covering 14,557 beneficiaries. The average spend per beneficiary was $275.38.

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