Medicare Part D coverage · clonazepam · RxCUI 349194
clonazepam 0.125 MG Disintegrating Oral Tablet
Per the CMS 2026 Part D formulary file, clonazepam 0.125 MG Disintegrating Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.6, with prior authorization required on 2.1% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.6
- Avg tier
- 2.1%
- Prior auth required
What the CMS Formulary Data Shows for clonazepam 0.125 MG Disintegrating Oral Tablet
Per the CMS 2026 Part D formulary file, clonazepam 0.125 MG Disintegrating Oral Tablet (RxNorm concept RXCUI 349194, generic name clonazepam) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.
Real-world access to clonazepam 0.125 MG Disintegrating Oral Tablet depends on utilization management as much as tier placement: 2.1% of covering formularies require prior authorization. 0.6% require step therapy. 90.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,317,240 Part D beneficiaries filled clonazepam 0.125 MG Disintegrating Oral Tablet in 2023, with total plan-and-beneficiary spending of $81,576,253 and an average per-beneficiary annual cost of $61.93. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry clonazepam 0.125 MG Disintegrating Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 2.1% of formularies
- Step therapy required
- 0.6% of formularies
- Quantity limits
- 90.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,317,240
- Total spending
- $81,576,253
- Avg per beneficiary
- $61.93
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering clonazepam 0.125 MG Disintegrating Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| 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 |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Generations Classic Rewards (HMO) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Classic Plus (HMO) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Chronic Care (HMO C-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Chronic Care Savings (HMO C-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Dual Support (HMO D-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Dual Premier (HMO D-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is clonazepam 0.125 MG Disintegrating Oral Tablet covered by Medicare Part D?
Yes, clonazepam 0.125 MG Disintegrating Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is clonazepam 0.125 MG Disintegrating Oral Tablet on Medicare Part D plans?
clonazepam 0.125 MG Disintegrating Oral Tablet averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does clonazepam 0.125 MG Disintegrating Oral Tablet require prior authorization?
2.1% of Part D formularies require prior authorization for clonazepam 0.125 MG Disintegrating Oral Tablet. Step therapy: 0.6%. Quantity limits: 90.5%.
How much does Medicare spend on clonazepam 0.125 MG Disintegrating Oral Tablet?
In 2023, total Medicare Part D spending on clonazepam 0.125 MG Disintegrating Oral Tablet was $81,576,253, covering 1,317,240 beneficiaries. The average spend per beneficiary was $61.93.
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
- 30 ACTUAT fluticasone furoate 0.2 MG/ACTUAT / umeclidinium 0.0625 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Trelegy] T2.6
- cefuroxime 750 MG Injection T2.6
- trifluridine 10 MG/ML Ophthalmic Solution T2.6
- haloperidol decanoate 50 MG/ML Injectable Solution T2.6
- amylase 120000 UNT / lipase 24000 UNT / protease 76000 UNT Delayed Release Oral Capsule [Creon] T2.6
- 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo] T2.6
Similar prior-authorization rate
- oxybutynin chloride 5 MG Oral Tablet 2.1% PA
- 24 HR trospium chloride 60 MG Extended Release Oral Capsule 2.1% PA
- pentamidine isethionate 300 MG Injection 2.1% PA
- felbamate 400 MG Oral Tablet 2.1% PA
- 24 HR oxybutynin chloride 10 MG Extended Release Oral Tablet 2.2% PA
- oxybutynin chloride 1 MG/ML Oral Solution 2.2% PA