Medicare Part D coverage · rifaximin · RxCUI 539789
rifaximin 200 MG Oral Tablet [XIFAXAN]
Per the CMS 2026 Part D formulary file, rifaximin 200 MG Oral Tablet [XIFAXAN] is covered by 2,798 Medicare Part D plans (55.4% of enrollable products), averaging Tier 3.1, with prior authorization required on 89.9% of covering formularies.
- 55.4%
- Plan coverage
- 2,798
- Plans covering
- T3.1
- Avg tier
- 89.9%
- Prior auth required
What the CMS Formulary Data Shows for rifaximin 200 MG Oral Tablet [XIFAXAN]
Per the CMS 2026 Part D formulary file, rifaximin 200 MG Oral Tablet [XIFAXAN] (RxNorm concept RXCUI 539789, generic name rifaximin) appears on 168 distinct formulary files spanning 2,798 Medicare Part D plan offerings - 55.4% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to rifaximin 200 MG Oral Tablet [XIFAXAN] depends on utilization management as much as tier placement: 89.9% of covering formularies require prior authorization. 0% require step therapy. 72.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 96,011 Part D beneficiaries filled rifaximin 200 MG Oral Tablet [XIFAXAN] in 2023, with total plan-and-beneficiary spending of $1,090,110,101 and an average per-beneficiary annual cost of $11,354.01. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry rifaximin 200 MG Oral Tablet [XIFAXAN] today.
Coverage Details
- Formularies covering
- 168
- Plans covering
- 2,798
- Coverage rate
- 55.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 89.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 72.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 96,011
- Total spending
- $1,090,110,101
- Avg per beneficiary
- $11,354.01
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering rifaximin 200 MG Oral Tablet [XIFAXAN]
100 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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
Show the next 30 plans
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | Yes | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $31.20 | MD |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | Yes | $31.40 | OH |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is rifaximin 200 MG Oral Tablet [XIFAXAN] covered by Medicare Part D?
Yes, rifaximin 200 MG Oral Tablet [XIFAXAN] is covered by 2,798 Medicare Part D plans (55.4% of all Part D formularies).
What tier is rifaximin 200 MG Oral Tablet [XIFAXAN] on Medicare Part D plans?
rifaximin 200 MG Oral Tablet [XIFAXAN] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does rifaximin 200 MG Oral Tablet [XIFAXAN] require prior authorization?
89.9% of Part D formularies require prior authorization for rifaximin 200 MG Oral Tablet [XIFAXAN]. Step therapy: 0%. Quantity limits: 72.6%.
How much does Medicare spend on rifaximin 200 MG Oral Tablet [XIFAXAN]?
In 2023, total Medicare Part D spending on rifaximin 200 MG Oral Tablet [XIFAXAN] was $1,090,110,101, covering 96,011 beneficiaries. The average spend per beneficiary was $11,354.01.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
- metronidazole 7.5 MG/ML Topical Lotion T3.1
- 5 ML hydromorphone hydrochloride 10 MG/ML Injection T3.1
- ospemifene 60 MG Oral Tablet [Osphena] T3.1
- 24 HR pramipexole dihydrochloride 0.75 MG Extended Release Oral Tablet T3.1
- levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] T3.1
- cyclosporine, modified 25 MG Oral Capsule [Neoral] T3.1
Similar prior-authorization rate
- 1.7 ML denosumab-bbdz 70 MG/ML Injection [Wyost] 89.9% PA
- 60 ACTUAT testosterone 20.25 MG/ACTUAT Topical Gel 89.9% PA
- 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] 90% PA
- deferiprone 500 MG Oral Tablet 90% PA
- deferiprone 1000 MG Oral Tablet 90% PA
- berdazimer 0.103 MG/MG Topical Gel [Zelsuvmi] 90% PA