Medicare Part D coverage · tramadol hydrochloride · RxCUI 2692878
tramadol hydrochloride 75 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 75 MG Oral Tablet is covered by 34 Medicare Part D plans (0.7% of enrollable products), averaging Tier 1.9, with prior authorization required on 7.7% of covering formularies.
- 0.7%
- Plan coverage
- 34
- Plans covering
- T1.9
- Avg tier
- 7.7%
- Prior auth required
What the CMS Formulary Data Shows for tramadol hydrochloride 75 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 75 MG Oral Tablet (RxNorm concept RXCUI 2692878, generic name tramadol hydrochloride) appears on 13 distinct formulary files spanning 34 Medicare Part D plan offerings - 0.7% 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 1.9.
Real-world access to tramadol hydrochloride 75 MG Oral Tablet depends on utilization management as much as tier placement: 7.7% of covering formularies require prior authorization. 0% require step therapy. 92.3% 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 75 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 75 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 13
- Plans covering
- 34
- Coverage rate
- 0.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 7.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 92.3% 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 75 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 75 MG Oral Tablet
32 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 |
| PrimeTime Health Plan Aultimate (HMO-POS) | Aultcare Health Insuring Corporation | T2 | No | $0 | OH |
| PrimeTime Health Plan Plus (HMO-POS) | Aultcare Health Insuring Corporation | T2 | No | $36.00 | OH |
| PrimeTime Health Plan Classic (HMO-POS) | Aultcare Health Insuring Corporation | T2 | No | $40.30 | OH |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | 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 |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T4 | No | $47.00 | PA |
| Security Blue HMO-POS Standard (HMO-POS) | Highmark Choice Company | T4 | Yes | $51.80 | PA |
Show the next 12 plans
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T4 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T4 | No | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T4 | No | $79.70 | PA |
| 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 |
| Personal Choice 65 Rx (PPO) | QCC Insurance Company | T4 | No | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC Insurance Company | T4 | No | $112.70 | 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 75 MG Oral Tablet covered by Medicare Part D?
Yes, tramadol hydrochloride 75 MG Oral Tablet is covered by 34 Medicare Part D plans (0.7% of all Part D formularies).
What tier is tramadol hydrochloride 75 MG Oral Tablet on Medicare Part D plans?
tramadol hydrochloride 75 MG Oral Tablet averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does tramadol hydrochloride 75 MG Oral Tablet require prior authorization?
7.7% of Part D formularies require prior authorization for tramadol hydrochloride 75 MG Oral Tablet. Step therapy: 0%. Quantity limits: 92.3%.
How much does Medicare spend on tramadol hydrochloride 75 MG Oral Tablet?
In 2023, total Medicare Part D spending on tramadol hydrochloride 75 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
- 24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule T1.9
- cephalexin 25 MG/ML Oral Suspension T1.9
- haloperidol 5 MG Oral Tablet T1.9
- memantine hydrochloride 10 MG Oral Tablet T1.9
- methylprednisolone 32 MG Oral Tablet T1.9
- Atrial Fibrillation sotalol hydrochloride 120 MG Oral Tablet T1.9
Similar prior-authorization rate
- fluoxetine 25 MG / olanzapine 6 MG Oral Capsule 7.7% PA
- tafluprost 0.015 MG/ML Ophthalmic Solution 7.7% PA
- 24 HR alprazolam 2 MG Extended Release Oral Tablet 7.7% PA
- baclofen 2 MG/ML Oral Solution 7.7% PA
- omadacycline 150 MG Oral Tablet [Nuzyra] 7.9% PA
- ampicillin 2000 MG / sulbactam 1000 MG Injection 7.9% PA