Medicare Part D coverage · sevelamer hydrochloride · RxCUI 857224
sevelamer hydrochloride 800 MG Oral Tablet
Per the CMS 2026 Part D formulary file, sevelamer hydrochloride 800 MG Oral Tablet is covered by 216 Medicare Part D plans (4.3% of enrollable products), averaging Tier 2.2, with prior authorization required on 3% of covering formularies.
- 4.3%
- Plan coverage
- 216
- Plans covering
- T2.2
- Avg tier
- 3%
- Prior auth required
What the CMS Formulary Data Shows for sevelamer hydrochloride 800 MG Oral Tablet
Per the CMS 2026 Part D formulary file, sevelamer hydrochloride 800 MG Oral Tablet (RxNorm concept RXCUI 857224, generic name sevelamer hydrochloride) appears on 66 distinct formulary files spanning 216 Medicare Part D plan offerings - 4.3% 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 2.2.
Real-world access to sevelamer hydrochloride 800 MG Oral Tablet depends on utilization management as much as tier placement: 3% of covering formularies require prior authorization. 0% require step therapy. 1.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 185,489 Part D beneficiaries filled sevelamer hydrochloride 800 MG Oral Tablet 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 hydrochloride 800 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 66
- Plans covering
- 216
- Coverage rate
- 4.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.5% 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 hydrochloride 800 MG Oral Tablet
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 |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $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 |
| 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 |
Show the next 30 plans
| 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 |
| Fallon Medicare Plus Orange (HMO) | Fallon Community Health Plan | T2 | No | $0 | MA |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T2 | No | $0 | CA |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Astiva Health Savings Plan (HMO) | Astiva Health, Inc. | T2 | No | $0 | CA |
| Astiva Health C-SNP Deluxe (HMO C-SNP) | Astiva Health, Inc. | T2 | No | $0 | CA |
| Astiva Health Savings Plan - NorCal (HMO) | Astiva Health, Inc. | T2 | No | $0 | CA |
| Astiva Health Premier Plan - NorCal (HMO) | Astiva Health, Inc. | T2 | No | $0 | CA |
| Astiva Health Premier Plan (HMO) | Astiva Health, Inc. | T2 | No | $0 | CA |
| ATRIO Prime Rx (HMO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Support Rx (PPO C-SNP) | Atrio Health Plans | T2 | No | $0 | OR |
| BayCarePlus Complete (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| BayCarePlus Rewards (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| BayCarePlus Premier (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| CommuniCare Advantage (HMO D-SNP) | Community Health Group | T2 | No | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sevelamer hydrochloride 800 MG Oral Tablet covered by Medicare Part D?
Yes, sevelamer hydrochloride 800 MG Oral Tablet is covered by 216 Medicare Part D plans (4.3% of all Part D formularies).
What tier is sevelamer hydrochloride 800 MG Oral Tablet on Medicare Part D plans?
sevelamer hydrochloride 800 MG Oral Tablet averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does sevelamer hydrochloride 800 MG Oral Tablet require prior authorization?
3% of Part D formularies require prior authorization for sevelamer hydrochloride 800 MG Oral Tablet. Step therapy: 0%. Quantity limits: 1.5%.
How much does Medicare spend on sevelamer hydrochloride 800 MG Oral Tablet?
In 2023, total Medicare Part D spending on sevelamer hydrochloride 800 MG Oral Tablet 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
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- {10 (nirmatrelvir 150 MG Oral Tablet) / 10 (ritonavir 100 MG Oral Tablet) } Pack [Paxlovid 150 MG /100 MG Dose Pack] T2.2
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- imiquimod 50 MG/ML Topical Cream T2.2
- Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] T2.2
Similar prior-authorization rate
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