sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension

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sulfamethoxazole

RxCUI: 313134

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.
99.9%
Plan Coverage
5,061
Plans Covering
T2.3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension

Per the CMS 2026 Part D formulary file, sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension (RxNorm concept RXCUI 313134, generic name sulfamethoxazole) appears on 329 distinct formulary files spanning 5,061 Medicare Part D plan offerings - 99.9% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.

Real-world access to sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0% 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 3,086,523 Part D beneficiaries filled sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $28,506,828 and an average per-beneficiary annual cost of $9.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension today.

Coverage Details

Formularies covering
329
Plans covering
5,061
Coverage rate
99.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

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

2023 Medicare Spending

Beneficiaries
3,086,523
Total spending
$28,506,828
Avg per beneficiary
$9.24

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering sulfamethoxazole 40 MG/ML / trimethoprim 8 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
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL

Frequently Asked Questions

Is sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension covered by Medicare Part D?

Yes, sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension is covered by 5,061 Medicare Part D plans (99.9% of all Part D formularies).

What tier is sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension on Medicare Part D plans?

sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension require prior authorization?

0% of Part D formularies require prior authorization for sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension?

In 2023, total Medicare Part D spending on sulfamethoxazole 40 MG/ML / trimethoprim 8 MG/ML Oral Suspension was $28,506,828, covering 3,086,523 beneficiaries. The average spend per beneficiary was $9.24.

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