PMDD fluoxetine 20 MG Oral Tablet
PMDD fluoxetine
RxCUI: 2532163
What the CMS Formulary Data Shows for PMDD fluoxetine 20 MG Oral Tablet
Per the CMS 2026 Part D formulary file, PMDD fluoxetine 20 MG Oral Tablet (RxNorm concept RXCUI 2532163, generic name PMDD fluoxetine) appears on 18 distinct formulary files spanning 442 Medicare Part D plan offerings - 8.7% 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 2.1.
Real-world access to PMDD fluoxetine 20 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 33.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry PMDD fluoxetine 20 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 18
- Plans covering
- 442
- Coverage rate
- 8.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 33.3% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering PMDD fluoxetine 20 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T1 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T1 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering PMDD fluoxetine 20 MG Oral Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| HAP Medicare Superior (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| Henry Ford Select (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| HAP Member Assist (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $8.80 | MI |
| HAP Medicare Complete Assist (PPO D-SNP) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $8.80 | MI |
| HAP Medicare Diabetes and Heart (HMO C-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $8.80 | MI |
| HAP Senior Plus Henry Ford Tiered Access (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $11.30 | MI |
| HAP Senior Plus (HMO-POS) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $13.50 | MI |
| HAP Senior Plus (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $42.60 | MI |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T1 | No | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T1 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $145.40 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T2 | No | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T2 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Complete Blue HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T2 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T2 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T2 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T2 | No | $0 | WV |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T2 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK BCBSD INC. | T2 | No | $0 | DE |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
Frequently Asked Questions
Is PMDD fluoxetine 20 MG Oral Tablet covered by Medicare Part D?
Yes, PMDD fluoxetine 20 MG Oral Tablet is covered by 442 Medicare Part D plans (8.7% of all Part D formularies).
What tier is PMDD fluoxetine 20 MG Oral Tablet on Medicare Part D plans?
PMDD fluoxetine 20 MG Oral Tablet averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does PMDD fluoxetine 20 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for PMDD fluoxetine 20 MG Oral Tablet. Step therapy: 0%. Quantity limits: 33.3%.
Read our methodology - how this data is sourced, computed, and verified.