Medicare Part D coverage · tedizolid phosphate · RxCUI 1540868
tedizolid phosphate 200 MG Oral Tablet [Sivextro]
Per the CMS 2026 Part D formulary file, tedizolid phosphate 200 MG Oral Tablet [Sivextro] is covered by 1,553 Medicare Part D plans (30.7% of enrollable products), averaging Tier 4.6, with prior authorization required on 69.4% of covering formularies.
- 30.7%
- Plan coverage
- 1,553
- Plans covering
- T4.6
- Avg tier
- 69.4%
- Prior auth required
What the CMS Formulary Data Shows for tedizolid phosphate 200 MG Oral Tablet [Sivextro]
Per the CMS 2026 Part D formulary file, tedizolid phosphate 200 MG Oral Tablet [Sivextro] (RxNorm concept RXCUI 1540868, generic name tedizolid phosphate) appears on 72 distinct formulary files spanning 1,553 Medicare Part D plan offerings - 30.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.6.
Real-world access to tedizolid phosphate 200 MG Oral Tablet [Sivextro] depends on utilization management as much as tier placement: 69.4% of covering formularies require prior authorization. 0% require step therapy. 29.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 489 Part D beneficiaries filled tedizolid phosphate 200 MG Oral Tablet [Sivextro] in 2023, with total plan-and-beneficiary spending of $11,498,831 and an average per-beneficiary annual cost of $23,514.99. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tedizolid phosphate 200 MG Oral Tablet [Sivextro] today.
Coverage Details
- Formularies covering
- 72
- Plans covering
- 1,553
- Coverage rate
- 30.7%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 69.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 29.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 489
- Total spending
- $11,498,831
- Avg per beneficiary
- $23,514.99
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tedizolid phosphate 200 MG Oral Tablet [Sivextro]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | Yes | $5.00 | OK |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | No | $0 | NV |
Show the next 30 plans
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T4 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T4 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T4 | No | $0 | NV |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T4 | No | $0 | MS |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is tedizolid phosphate 200 MG Oral Tablet [Sivextro] covered by Medicare Part D?
Yes, tedizolid phosphate 200 MG Oral Tablet [Sivextro] is covered by 1,553 Medicare Part D plans (30.7% of all Part D formularies).
What tier is tedizolid phosphate 200 MG Oral Tablet [Sivextro] on Medicare Part D plans?
tedizolid phosphate 200 MG Oral Tablet [Sivextro] averages Tier 4.6 across Part D plans, ranging from Tier 1 to Tier 6.
Does tedizolid phosphate 200 MG Oral Tablet [Sivextro] require prior authorization?
69.4% of Part D formularies require prior authorization for tedizolid phosphate 200 MG Oral Tablet [Sivextro]. Step therapy: 0%. Quantity limits: 29.2%.
How much does Medicare spend on tedizolid phosphate 200 MG Oral Tablet [Sivextro]?
In 2023, total Medicare Part D spending on tedizolid phosphate 200 MG Oral Tablet [Sivextro] was $11,498,831, covering 489 beneficiaries. The average spend per beneficiary was $23,514.99.
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
- {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 1 Titration Kit] T4.6
- 12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram] T4.6
- paromomycin 250 MG Oral Capsule [Humatin] T4.6
- omaveloxolone 50 MG Oral Capsule [Skyclarys] T4.6
- 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] T4.6
- 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Vabrinty] T4.6
Similar prior-authorization rate
- doxepin hydrochloride 50 MG/ML Topical Cream 69.2% PA
- sodium phenylbutyrate 0.94 MG/MG Oral Powder 69.2% PA
- 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe 69.2% PA
- 0.2 ML adalimumab-adaz 100 MG/ML Prefilled Syringe 69.2% PA
- 0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector 69.2% PA
- aripiprazole 2 MG Oral Film [Opipza] 69.8% PA