Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch
Twice-Daily diclofenac epolamine
RxCUI: 855626
What the CMS Formulary Data Shows for Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch
Per the CMS 2026 Part D formulary file, Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch (RxNorm concept RXCUI 855626, generic name Twice-Daily diclofenac epolamine) appears on 82 distinct formulary files spanning 264 Medicare Part D plan offerings - 5.2% 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 2.9.
Real-world access to Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch depends on utilization management as much as tier placement: 81.7% of covering formularies require prior authorization. 0% require step therapy. 79.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch today.
Coverage Details
- Formularies covering
- 82
- Plans covering
- 264
- Coverage rate
- 5.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 81.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 79.3% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | Yes | $0 | CA |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | Yes | $0 | WI |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $58.80 | NY |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T2 | No | $0 | NC |
Frequently Asked Questions
Is Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch covered by Medicare Part D?
Yes, Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch is covered by 264 Medicare Part D plans (5.2% of all Part D formularies).
What tier is Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch on Medicare Part D plans?
Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch require prior authorization?
81.7% of Part D formularies require prior authorization for Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch. Step therapy: 0%. Quantity limits: 79.3%.
Read our methodology - how this data is sourced, computed, and verified.