Medicare Part D coverage · alprazolam · RxCUI 485413
alprazolam 0.25 MG Disintegrating Oral Tablet
Per the CMS 2026 Part D formulary file, alprazolam 0.25 MG Disintegrating Oral Tablet is covered by 280 Medicare Part D plans (5.5% of enrollable products), averaging Tier 2.4, with prior authorization required on 5% of covering formularies.
- 5.5%
- Plan coverage
- 280
- Plans covering
- T2.4
- Avg tier
- 5%
- Prior auth required
What the CMS Formulary Data Shows for alprazolam 0.25 MG Disintegrating Oral Tablet
Per the CMS 2026 Part D formulary file, alprazolam 0.25 MG Disintegrating Oral Tablet (RxNorm concept RXCUI 485413, generic name alprazolam) appears on 20 distinct formulary files spanning 280 Medicare Part D plan offerings - 5.5% 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 2.4.
Real-world access to alprazolam 0.25 MG Disintegrating Oral Tablet depends on utilization management as much as tier placement: 5% of covering formularies require prior authorization. 0% require step therapy. 70% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,265,351 Part D beneficiaries filled alprazolam 0.25 MG Disintegrating Oral Tablet in 2023, with total plan-and-beneficiary spending of $77,541,550 and an average per-beneficiary annual cost of $34.23. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry alprazolam 0.25 MG Disintegrating Oral Tablet today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 280
- Coverage rate
- 5.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 70% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,265,351
- Total spending
- $77,541,550
- Avg per beneficiary
- $34.23
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering alprazolam 0.25 MG Disintegrating Oral Tablet
100 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| 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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $31.20 | DE |
| 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 |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
Show the next 30 plans
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is alprazolam 0.25 MG Disintegrating Oral Tablet covered by Medicare Part D?
Yes, alprazolam 0.25 MG Disintegrating Oral Tablet is covered by 280 Medicare Part D plans (5.5% of all Part D formularies).
What tier is alprazolam 0.25 MG Disintegrating Oral Tablet on Medicare Part D plans?
alprazolam 0.25 MG Disintegrating Oral Tablet averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does alprazolam 0.25 MG Disintegrating Oral Tablet require prior authorization?
5% of Part D formularies require prior authorization for alprazolam 0.25 MG Disintegrating Oral Tablet. Step therapy: 0%. Quantity limits: 70%.
How much does Medicare spend on alprazolam 0.25 MG Disintegrating Oral Tablet?
In 2023, total Medicare Part D spending on alprazolam 0.25 MG Disintegrating Oral Tablet was $77,541,550, covering 2,265,351 beneficiaries. The average spend per beneficiary was $34.23.
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
Similar prior-authorization rate
- flurazepam hydrochloride 30 MG Oral Capsule 5% PA
- trimipramine 100 MG Oral Capsule 4.9% PA
- 0.15 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 4.8% PA
- 0.2 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 4.8% PA
- 0.25 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 4.8% PA
- 0.45 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 4.8% PA