FillMapPacificSource Medicare Essentials Rx 27 (HMO)

Does PacificSource Medicare Essentials Rx 27 (HMO) cover methylphenidate?

PacificSource Medicare Essentials Rx 27 (HMO)
H3864-027-0 · MA_LOCAL · Medicare Part D
methylphenidate
Do you get help with your Medicare drug costs?None of these

Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.

methylphenidateunder PacificSource Medicare Essentials Rx 27 (HMO)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$8per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Amount limit applies — how much depends on the strength you are prescribed — the cap for each one is listed below. You can still fill it; more than that needs your plan's approval, which your doctor's office requests.
Tier
Tier 2
Approval first
Not needed
Try another first
No
Amount limit
Varies by strength
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.

Covered forms and strengths (34)

  • 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletTier 230 tablets per 30 days
  • 24 HR methylphenidate hydrochloride 72 MG Extended Release Oral TabletTier 230 tablets per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral CapsuleTier 260 capsules per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral CapsuleTier 260 capsules per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral CapsuleTier 260 capsules per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 50 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 30/70 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 50/50 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral CapsuleTier 260 capsules per 30 days
  • 50/50 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral CapsuleTier 260 capsules per 30 days
  • 50/50 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 50/50 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 50/50 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral CapsuleTier 230 capsules per 30 days
  • 8 HR methylphenidate hydrochloride 10 MG Extended Release Oral TabletTier 290 tablets per 30 days
  • 8 HR methylphenidate hydrochloride 20 MG Extended Release Oral TabletTier 290 tablets per 30 days
  • 9 HR methylphenidate 1.11 MG/HR Transdermal SystemTier 430 patches per 30 days
  • 9 HR methylphenidate 1.67 MG/HR Transdermal SystemTier 430 patches per 30 days
  • 9 HR methylphenidate 2.22 MG/HR Transdermal SystemTier 430 patches per 30 days
  • 9 HR methylphenidate 3.33 MG/HR Transdermal SystemTier 430 patches per 30 days
  • BX Rating 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • BX Rating 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • BX Rating 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletTier 260 tablets per 30 days
  • BX Rating 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletTier 230 tablets per 30 days
  • methylphenidate hydrochloride 1 MG/ML Oral SolutionTier 21800 mL per 30 days
  • methylphenidate hydrochloride 10 MG Chewable TabletTier 2180 tablets per 30 days
  • methylphenidate hydrochloride 10 MG Oral TabletTier 2180 tablets per 30 days
  • methylphenidate hydrochloride 2 MG/ML Oral SolutionTier 4900 mL per 30 days
  • methylphenidate hydrochloride 2.5 MG Chewable TabletTier 2180 tablets per 30 days
  • methylphenidate hydrochloride 20 MG Oral TabletTier 290 tablets per 30 days
  • methylphenidate hydrochloride 5 MG Chewable TabletTier 2180 tablets per 30 days
  • methylphenidate hydrochloride 5 MG Oral TabletTier 2180 tablets per 30 days

← All coverage for methylphenidate