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Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate 3.75 mg/1 / 3.75 mg/1 / 3.75 mg/1 / 3.75 mg/1 Medicare Part D Coverage

Dosage form
TABLET
Route
ORAL
100%
of Medicare Part D plans
cover Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate
5,521 of 5,530 plans
2.7
Avg. formulary tier
$12.00
Median 30-day copay
$0.00–$24.00
Copay range

Formulary Tier Distribution

How Medicare Part D plans classify Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate. Lower tiers = lower copays.

Tier 1 - Preferred Generic 6%
316 plans • avg $0.00/mo
Tier 2 - Generic 19%
1,049 plans • avg $2.17/mo
Tier 3 - Preferred Brand 73%
4,008 plans • avg $4.29/mo
Tier 4 - Non-Preferred Drug 3%
148 plans • avg $94.50/mo

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Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate Medicare Coverage by State

Coverage rates and average costs vary significantly by state. Click a state to see the specific plans available there.

Alternative Medications in the Same Drug Class

Other drugs in the ADHD Medications that Medicare Part D plans also cover.

Frequently Asked Questions about Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate

100% of Medicare Part D plans cover Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate. It is most commonly placed on Tier 3. Coverage varies by plan and geographic area.

The median 30-day copay for Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate on Medicare Part D is $12.00 at a preferred pharmacy. Costs range from $0.00 to $24.00 depending on the plan.

Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate is placed on Tier 3 by most Medicare Part D plans. Lower tier numbers generally mean lower copays.

0% of plans require prior authorization for Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

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Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →