olanzapine 10 MG Injection [Zyprexa]

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olanzapine

RxCUI: 545353

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.
16.9%
Plan Coverage
855
Plans Covering
T3.6
Avg Tier
12.5%
Prior Auth Required

What the CMS Formulary Data Shows for olanzapine 10 MG Injection [Zyprexa]

Per the CMS 2026 Part D formulary file, olanzapine 10 MG Injection [Zyprexa] (RxNorm concept RXCUI 545353, generic name olanzapine) appears on 8 distinct formulary files spanning 855 Medicare Part D plan offerings - 16.9% 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 3.6.

Real-world access to olanzapine 10 MG Injection [Zyprexa] depends on utilization management as much as tier placement: 12.5% of covering formularies require prior authorization. 0% require step therapy. 12.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 516,737 Part D beneficiaries filled olanzapine 10 MG Injection [Zyprexa] in 2023, with total plan-and-beneficiary spending of $127,379,077 and an average per-beneficiary annual cost of $246.51. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry olanzapine 10 MG Injection [Zyprexa] today.

Coverage Details

Formularies covering
8
Plans covering
855
Coverage rate
16.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
12.5% of formularies
Step therapy required
0% of formularies
Quantity limits
12.5% of formularies

2023 Medicare Spending

Beneficiaries
516,737
Total spending
$127,379,077
Avg per beneficiary
$246.51

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
98 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering olanzapine 10 MG Injection [Zyprexa]

26 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 No No $0 -

Medicare Advantage Plans (MA-PD) Covering olanzapine 10 MG Injection [Zyprexa]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Humana Gold Plus H0028-014 (HMO) CHA HMO, INC. T4 No $0 IL, MO
Humana Gold Plus H0028-019 (HMO) CHA HMO, INC. T4 No $0 NM
Humana Gold Plus H0028-021 (HMO) CHA HMO, INC. T4 No $0 AZ
Humana Gold Plus H0028-024 (HMO) CHA HMO, INC. T4 No $0 AZ
Humana Gold Plus H0028-028 (HMO) CHA HMO, INC. T4 No $0 AZ
Humana Gold Plus H0028-029 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-030 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-035 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-037 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-041 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-042 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-043 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-046 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-053 (HMO) CHA HMO, INC. T4 No $0 IA, NE
Humana Gold Plus H0028-054 (HMO-POS) CHA HMO, INC. T4 No $0 KS, MO
Humana Gold Plus H0028-059 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-062 (HMO) CHA HMO, INC. T4 No $0 AZ
Humana Essentials Plus Giveback H0028-063 (HMO) CHA HMO, INC. T4 No $0 CO
Humana Gold Plus Giveback H0028-065 (HMO) CHA HMO, INC. T4 No $0 IL, MO
Humana Gold Plus Giveback H0028-066 (HMO-POS) CHA HMO, INC. T4 No $0 KS, MO
Humana Gold Plus H0028-072 (HMO) CHA HMO, INC. T4 No $0 TX
Humana Gold Plus H0028-074 (HMO) CHA HMO, INC. T4 No $0 AZ
Humana Dual Select H0028-078 (HMO D-SNP) CHA HMO, INC. T4 No $0 CO
Humana Dual Select H0028-079 (HMO D-SNP) CHA HMO, INC. T4 No $0 CO
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) CHA HMO, INC. T4 No $0 NE
Humana Total Complete H0028-081 (HMO) CHA HMO, INC. T4 No $0 CO
Humana Gold Plus H0028-082 (HMO) CHA HMO, INC. T4 No $0 HI
Humana Community (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T4 No $0 KY
Humana Gold Plus H0292-002 (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T4 No $0 KY
Humana Gold Plus H0292-003 (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T4 No $0 KY
HumanaChoice H0473-004 (PPO) HUMANA INSURANCE COMPANY OF KENTUCKY T4 No $0 TX
HumanaChoice H0473-005 (PPO) HUMANA INSURANCE COMPANY OF KENTUCKY T4 No $0 TX
Humana Gold Plus H0783-004 (HMO) HUMANA BENEFIT PLAN OF TEXAS, INC. T4 No $0 TX
Humana Gold Plus H1036-137 (HMO-POS) HUMANA MEDICAL PLAN, INC. T4 No $0 NC
Humana Gold Plus H1036-151 (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 MS
Humana Gold Plus H1036-153 (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 OR
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T4 No $0 NC
Humana Gold Plus SNP-DE H1036-222 (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T4 No $0 MS
Humana Gold Plus H1036-229 (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 FL
Humana Gold Plus H1036-233 (HMO-POS) HUMANA MEDICAL PLAN, INC. T4 No $0 NC
Humana Community HMO SNP-DE (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T4 No $0 KY
Humana Community (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 KY
Humana Gold Plus Giveback H1036-286 (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 FL
Humana Gold Plus Giveback H1036-318 (HMO-POS) HUMANA MEDICAL PLAN, INC. T4 No $0 NC
Humana Gold Plus Giveback H1036-319 (HMO) HUMANA MEDICAL PLAN, INC. T4 No $0 WA
Humana Gold Plus SNP-DE H1036-320 (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T4 No $0 KY

Frequently Asked Questions

Is olanzapine 10 MG Injection [Zyprexa] covered by Medicare Part D?

Yes, olanzapine 10 MG Injection [Zyprexa] is covered by 855 Medicare Part D plans (16.9% of all Part D formularies).

What tier is olanzapine 10 MG Injection [Zyprexa] on Medicare Part D plans?

olanzapine 10 MG Injection [Zyprexa] averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does olanzapine 10 MG Injection [Zyprexa] require prior authorization?

12.5% of Part D formularies require prior authorization for olanzapine 10 MG Injection [Zyprexa]. Step therapy: 0%. Quantity limits: 12.5%.

How much does Medicare spend on olanzapine 10 MG Injection [Zyprexa]?

In 2023, total Medicare Part D spending on olanzapine 10 MG Injection [Zyprexa] was $127,379,077, covering 516,737 beneficiaries. The average spend per beneficiary was $246.51.

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