Medicare Part D coverage · sevelamer carbonate · RxCUI 861375
sevelamer carbonate 800 MG Powder for Oral Suspension
Per the CMS 2026 Part D formulary file, sevelamer carbonate 800 MG Powder for Oral Suspension is covered by 1,479 Medicare Part D plans (29.3% of enrollable products), averaging Tier 2.5, with prior authorization required on 19.8% of covering formularies.
- 29.3%
- Plan coverage
- 1,479
- Plans covering
- T2.5
- Avg tier
- 19.8%
- Prior auth required
What the CMS Formulary Data Shows for sevelamer carbonate 800 MG Powder for Oral Suspension
Per the CMS 2026 Part D formulary file, sevelamer carbonate 800 MG Powder for Oral Suspension (RxNorm concept RXCUI 861375, generic name sevelamer carbonate) appears on 101 distinct formulary files spanning 1,479 Medicare Part D plan offerings - 29.3% 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 2.5.
Real-world access to sevelamer carbonate 800 MG Powder for Oral Suspension depends on utilization management as much as tier placement: 19.8% of covering formularies require prior authorization. 0% require step therapy. 14.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 185,489 Part D beneficiaries filled sevelamer carbonate 800 MG Powder for Oral Suspension in 2023, with total plan-and-beneficiary spending of $189,365,581 and an average per-beneficiary annual cost of $1,020.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sevelamer carbonate 800 MG Powder for Oral Suspension today.
Coverage Details
- Formularies covering
- 101
- Plans covering
- 1,479
- Coverage rate
- 29.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 19.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 14.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 185,489
- Total spending
- $189,365,581
- Avg per beneficiary
- $1,020.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sevelamer carbonate 800 MG Powder for Oral Suspension
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
Show the next 30 plans
| 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 |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $58.80 | NY |
| Troy Medicare (HMO) | Troy Health, Inc. | T2 | No | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T2 | No | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T2 | No | $0 | CA |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T2 | No | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T2 | No | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T2 | No | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T2 | No | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T2 | No | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T2 | No | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sevelamer carbonate 800 MG Powder for Oral Suspension covered by Medicare Part D?
Yes, sevelamer carbonate 800 MG Powder for Oral Suspension is covered by 1,479 Medicare Part D plans (29.3% of all Part D formularies).
What tier is sevelamer carbonate 800 MG Powder for Oral Suspension on Medicare Part D plans?
sevelamer carbonate 800 MG Powder for Oral Suspension averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does sevelamer carbonate 800 MG Powder for Oral Suspension require prior authorization?
19.8% of Part D formularies require prior authorization for sevelamer carbonate 800 MG Powder for Oral Suspension. Step therapy: 0%. Quantity limits: 14.9%.
How much does Medicare spend on sevelamer carbonate 800 MG Powder for Oral Suspension?
In 2023, total Medicare Part D spending on sevelamer carbonate 800 MG Powder for Oral Suspension was $189,365,581, covering 185,489 beneficiaries. The average spend per beneficiary was $1,020.90.
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
- anagrelide 1 MG Oral Capsule T2.5
- 100 ML sodium chloride 9 MG/ML Injection T2.5
- 12 HR acetazolamide 500 MG Extended Release Oral Capsule T2.5
- caffeine 100 MG / ergotamine tartrate 1 MG Oral Tablet T2.5
- 1000 ML potassium chloride 0.02 MEQ/ML / sodium chloride 9 MG/ML Injection T2.5
- 21 DAY ethinyl estradiol 0.000625 MG/HR / etonogestrel 0.005 MG/HR Vaginal System [Enilloring] T2.5
Similar prior-authorization rate
- linezolid 600 MG Oral Tablet 19.8% PA
- patiromer 25200 MG Powder for Oral Suspension [Veltassa] 19.8% PA
- amphetamine aspartate 7.5 MG / amphetamine sulfate 7.5 MG / dextroamphetamine saccharate 7.5 MG / dextroamphetamine sulfate 7.5 MG Oral Tablet 19.9% PA
- fidaxomicin 40 MG/ML Oral Suspension [Dificid] 19.7% PA
- glyburide 2.5 MG / metformin hydrochloride 500 MG Oral Tablet 19.7% PA
- glyburide 1.25 MG / metformin hydrochloride 250 MG Oral Tablet 19.7% PA