sucralfate 100 MG/ML Oral Suspension

Verify with CMS →

sucralfate

RxCUI: 313123

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
71.9%
Plan Coverage
3,642
Plans Covering
T3
Avg Tier
0.6%
Prior Auth Required

What the CMS Formulary Data Shows for sucralfate 100 MG/ML Oral Suspension

Per the CMS 2026 Part D formulary file, sucralfate 100 MG/ML Oral Suspension (RxNorm concept RXCUI 313123, generic name sucralfate) appears on 164 distinct formulary files spanning 3,642 Medicare Part D plan offerings - 71.9% 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.

Real-world access to sucralfate 100 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0.6% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 800,942 Part D beneficiaries filled sucralfate 100 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $160,271,432 and an average per-beneficiary annual cost of $200.10. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sucralfate 100 MG/ML Oral Suspension today.

Coverage Details

Formularies covering
164
Plans covering
3,642
Coverage rate
71.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0.6% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
800,942
Total spending
$160,271,432
Avg per beneficiary
$200.10

Tier Distribution Across Plans

95 plans
Tier 1, Preferred Generic
5 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering sucralfate 100 MG/ML Oral Suspension

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 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
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
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
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
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 No $4.80 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 No $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 No $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
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
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 No $8.80 MI
Senior Care (HMO I-SNP) ALIGN SENIOR CARE MI, LLC T1 No $8.80 MI
Tribute Select (HMO-POS I-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $8.90 AR
AgeRight Advantage Health Plan (HMO I-SNP) MARQUIS ADVANTAGE, INC. T1 No $10.50 OR, WA

Frequently Asked Questions

Is sucralfate 100 MG/ML Oral Suspension covered by Medicare Part D?

Yes, sucralfate 100 MG/ML Oral Suspension is covered by 3,642 Medicare Part D plans (71.9% of all Part D formularies).

What tier is sucralfate 100 MG/ML Oral Suspension on Medicare Part D plans?

sucralfate 100 MG/ML Oral Suspension averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.

Does sucralfate 100 MG/ML Oral Suspension require prior authorization?

0.6% of Part D formularies require prior authorization for sucralfate 100 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on sucralfate 100 MG/ML Oral Suspension?

In 2023, total Medicare Part D spending on sucralfate 100 MG/ML Oral Suspension was $160,271,432, covering 800,942 beneficiaries. The average spend per beneficiary was $200.10.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial