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Prochlorperazine 25 mg/1 Medicare Part D Coverage

Dosage form
SUPPOSITORY
Route
RECTAL
100%
of Medicare Part D plans
cover Prochlorperazine
5,529 of 5,530 plans
3.6
Avg. formulary tier
$12.00
Median 30-day copay
$0.00–$24.00
Copay range

Formulary Tier Distribution

How Medicare Part D plans classify Prochlorperazine. Lower tiers = lower copays.

Tier 1 - Preferred Generic 4%
212 plans • avg $0.00/mo
Tier 2 - Generic 13%
699 plans • avg $1.05/mo
Tier 3 - Preferred Brand 2%
88 plans • avg $12.95/mo
Tier 4 - Non-Preferred Drug 82%
4,530 plans • avg $4.25/mo

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Prochlorperazine Medicare Coverage by State

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

Frequently Asked Questions about Prochlorperazine

100% of Medicare Part D plans cover Prochlorperazine. It is most commonly placed on Tier 4. Coverage varies by plan and geographic area.

The median 30-day copay for Prochlorperazine on Medicare Part D is $12.00 at a preferred pharmacy. Costs range from $0.00 to $24.00 depending on the plan.

Prochlorperazine is placed on Tier 4 by most Medicare Part D plans. Lower tier numbers generally mean lower copays.

0% of plans require prior authorization for Prochlorperazine. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

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