Medicare Part D coverage · olanzapine · RxCUI 545353
olanzapine 10 MG Injection [Zyprexa]
Per the CMS 2026 Part D formulary file, olanzapine 10 MG Injection [Zyprexa] is covered by 855 Medicare Part D plans (16.9% of enrollable products), averaging Tier 3.6, with prior authorization required on 12.5% of covering formularies.
- 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
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 | - |
Show the next 6 plans
| 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.
Show the next 30 plans
| 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 |
Showing top 50 of 74 plans.
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.
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
- toremifene 60 MG Oral Tablet T3.6
- voriconazole 200 MG Injection T3.6
- 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] T3.6
- ceftolozane 1000 MG / tazobactam 500 MG Injection [Zerbaxa] T3.6
- epoetin alfa 20000 UNT/ML Injectable Solution [Epogen] T3.6
- lopinavir 80 MG/ML / ritonavir 20 MG/ML Oral Solution [Kaletra] T3.6
Similar prior-authorization rate
- 200 ML fluconazole 2 MG/ML Injection 12.5% PA
- 3 ML insulin glargine-aglr 100 UNT/ML Pen Injector [Rezvoglar] 12.5% PA
- 100 ML fluconazole 2 MG/ML Injection 12.5% PA
- levorphanol tartrate 2 MG Oral Tablet 12.5% PA
- caspofungin acetate 70 MG Injection 12.5% PA
- insulin aspart-szjj 100 UNT/ML Injectable Solution [Merilog] 12.5% PA