estazolam 1 MG Oral Tablet

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estazolam

RxCUI: 197653

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
3.7%
Plan Coverage
186
Plans Covering
T1.9
Avg Tier
23.5%
Prior Auth Required

What the CMS Formulary Data Shows for estazolam 1 MG Oral Tablet

Per the CMS 2026 Part D formulary file, estazolam 1 MG Oral Tablet (RxNorm concept RXCUI 197653, generic name estazolam) appears on 17 distinct formulary files spanning 186 Medicare Part D plan offerings - 3.7% 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 1.9.

Real-world access to estazolam 1 MG Oral Tablet depends on utilization management as much as tier placement: 23.5% of covering formularies require prior authorization. 0% require step therapy. 94.1% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 13,042 Part D beneficiaries filled estazolam 1 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $4,926,725 and an average per-beneficiary annual cost of $377.76. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry estazolam 1 MG Oral Tablet today.

Coverage Details

Formularies covering
17
Plans covering
186
Coverage rate
3.7%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
23.5% of formularies
Step therapy required
0% of formularies
Quantity limits
94.1% of formularies

2023 Medicare Spending

Beneficiaries
13,042
Total spending
$4,926,725
Avg per beneficiary
$377.76

Tier Distribution Across Plans

48 plans
Tier 1, Preferred Generic
52 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering estazolam 1 MG Oral Tablet

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T1 No $51.60 NY
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL

Frequently Asked Questions

Is estazolam 1 MG Oral Tablet covered by Medicare Part D?

Yes, estazolam 1 MG Oral Tablet is covered by 186 Medicare Part D plans (3.7% of all Part D formularies).

What tier is estazolam 1 MG Oral Tablet on Medicare Part D plans?

estazolam 1 MG Oral Tablet averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does estazolam 1 MG Oral Tablet require prior authorization?

23.5% of Part D formularies require prior authorization for estazolam 1 MG Oral Tablet. Step therapy: 0%. Quantity limits: 94.1%.

How much does Medicare spend on estazolam 1 MG Oral Tablet?

In 2023, total Medicare Part D spending on estazolam 1 MG Oral Tablet was $4,926,725, covering 13,042 beneficiaries. The average spend per beneficiary was $377.76.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial