Medicare Part D coverage · tramadol hydrochloride · RxCUI 2670390
tramadol hydrochloride 25 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 25 MG Oral Tablet is covered by 29 Medicare Part D plans (0.6% of enrollable products), averaging Tier 1.8, with prior authorization required on 8.3% of covering formularies.
- 0.6%
- Plan coverage
- 29
- Plans covering
- T1.8
- Avg tier
- 8.3%
- Prior auth required
What the CMS Formulary Data Shows for tramadol hydrochloride 25 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 25 MG Oral Tablet (RxNorm concept RXCUI 2670390, generic name tramadol hydrochloride) appears on 12 distinct formulary files spanning 29 Medicare Part D plan offerings - 0.6% 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 1.8.
Real-world access to tramadol hydrochloride 25 MG Oral Tablet depends on utilization management as much as tier placement: 8.3% of covering formularies require prior authorization. 0% require step therapy. 91.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,884,717 Part D beneficiaries filled tramadol hydrochloride 25 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $91,670,187 and an average per-beneficiary annual cost of $23.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tramadol hydrochloride 25 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 29
- Coverage rate
- 0.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 8.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 91.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,884,717
- Total spending
- $91,670,187
- Avg per beneficiary
- $23.60
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering tramadol hydrochloride 25 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM Health Insurance Company | T4 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM Health Insurance Company | T4 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering tramadol hydrochloride 25 MG Oral Tablet
27 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 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 |
| Health New England Medicare Compass (PPO) | Health NEW England, Inc. | T3 | No | $0 | MA |
| Health New England Medicare Value (HMO) | Health NEW England, Inc. | T3 | No | $0 | MA |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
| Health New England Medicare Premium (HMO) | Health NEW England, Inc. | T3 | No | $15.80 | MA |
| Health New England Medicare Plus (HMO) | Health NEW England, Inc. | T3 | No | $58.40 | MA |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| Security Blue HMO-POS Standard (HMO-POS) | Highmark Choice Company | T4 | Yes | $51.80 | PA |
Show the next 7 plans
| Freedom Blue PPO Select (PPO) | Highmark Senior Health Company | T4 | Yes | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | Highmark Choice Company | T4 | Yes | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | Highmark Senior Health Company | T4 | Yes | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | Highmark Senior Health Company | T4 | Yes | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | Highmark Senior Health Company | T4 | Yes | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | Highmark Senior Health Company | T4 | Yes | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | Highmark Senior Health Company | T4 | Yes | $145.40 | PA |
Frequently Asked Questions
Is tramadol hydrochloride 25 MG Oral Tablet covered by Medicare Part D?
Yes, tramadol hydrochloride 25 MG Oral Tablet is covered by 29 Medicare Part D plans (0.6% of all Part D formularies).
What tier is tramadol hydrochloride 25 MG Oral Tablet on Medicare Part D plans?
tramadol hydrochloride 25 MG Oral Tablet averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does tramadol hydrochloride 25 MG Oral Tablet require prior authorization?
8.3% of Part D formularies require prior authorization for tramadol hydrochloride 25 MG Oral Tablet. Step therapy: 0%. Quantity limits: 91.7%.
How much does Medicare spend on tramadol hydrochloride 25 MG Oral Tablet?
In 2023, total Medicare Part D spending on tramadol hydrochloride 25 MG Oral Tablet was $91,670,187, covering 3,884,717 beneficiaries. The average spend per beneficiary was $23.60.
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
Similar prior-authorization rate
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