Medicare Part D coverage · sertraline · RxCUI 251201
sertraline 200 MG Oral Capsule
Per the CMS 2026 Part D formulary file, sertraline 200 MG Oral Capsule is covered by 169 Medicare Part D plans (3.3% of enrollable products), averaging Tier 3.1, with prior authorization required on 0% of covering formularies.
- 3.3%
- Plan coverage
- 169
- Plans covering
- T3.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for sertraline 200 MG Oral Capsule
Per the CMS 2026 Part D formulary file, sertraline 200 MG Oral Capsule (RxNorm concept RXCUI 251201, generic name sertraline) appears on 9 distinct formulary files spanning 169 Medicare Part D plan offerings - 3.3% 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 3.1.
Real-world access to sertraline 200 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 11.1% require step therapy. 22.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,041,276 Part D beneficiaries filled sertraline 200 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $173,568,097 and an average per-beneficiary annual cost of $57.07. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sertraline 200 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 169
- Coverage rate
- 3.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 11.1% of formularies
- Quantity limits
- 22.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,041,276
- Total spending
- $173,568,097
- Avg per beneficiary
- $57.07
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sertraline 200 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| MCS Classicare RxMax (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MMM Supremo (HMO C-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sertraline 200 MG Oral Capsule covered by Medicare Part D?
Yes, sertraline 200 MG Oral Capsule is covered by 169 Medicare Part D plans (3.3% of all Part D formularies).
What tier is sertraline 200 MG Oral Capsule on Medicare Part D plans?
sertraline 200 MG Oral Capsule averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does sertraline 200 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for sertraline 200 MG Oral Capsule. Step therapy: 11.1%. Quantity limits: 22.2%.
How much does Medicare spend on sertraline 200 MG Oral Capsule?
In 2023, total Medicare Part D spending on sertraline 200 MG Oral Capsule was $173,568,097, covering 3,041,276 beneficiaries. The average spend per beneficiary was $57.07.
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.
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