selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar]

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selegiline hydrochloride

RxCUI: 859192

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.
2.7%
Plan Coverage
138
Plans Covering
T4.8
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar]

Per the CMS 2026 Part D formulary file, selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] (RxNorm concept RXCUI 859192, generic name selegiline hydrochloride) appears on 5 distinct formulary files spanning 138 Medicare Part D plan offerings - 2.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 5, with a cross-plan average of Tier 4.8.

Real-world access to selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 877 Part D beneficiaries filled selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] in 2023, with total plan-and-beneficiary spending of $12,397,890 and an average per-beneficiary annual cost of $14,136.70. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] today.

Coverage Details

Formularies covering
5
Plans covering
138
Coverage rate
2.7%
Tier range
Tier 4 – Tier 5
Average tier
Tier 5, Specialty

Restrictions

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

2023 Medicare Spending

Beneficiaries
877
Total spending
$12,397,890
Avg per beneficiary
$14,136.70

Tier Distribution Across Plans

12 plans
Tier 4, Non-Preferred
88 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar]

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

Plan Insurer Tier PA Premium States
PacificSource Medicare Essentials Rx 27 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 MT
PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Medicare MyCare Rx 40 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Dual Care (HMO D-SNP) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Dual Care Alliance (HMO D-SNP) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $19.00 ID
PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $29.10 OR
PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $52.00 ID
PacificSource Medicare Essentials Rx 41 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $69.30 OR
PacificSource Medicare Explorer Rx 4 (PPO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $88.70 OR
PacificSource Medicare Essentials Rx 6 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $105.90 OR
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF CO T5 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T5 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) KAISER FOUNDATION HP OF GA, INC. T5 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T5 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) KAISER FOUNDATION HP OF GA, INC. T5 No $0 GA

Frequently Asked Questions

Is selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] covered by Medicare Part D?

Yes, selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] is covered by 138 Medicare Part D plans (2.7% of all Part D formularies).

What tier is selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] on Medicare Part D plans?

selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] averages Tier 4.8 across Part D plans, ranging from Tier 4 to Tier 5.

Does selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] require prior authorization?

0% of Part D formularies require prior authorization for selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar]?

In 2023, total Medicare Part D spending on selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] was $12,397,890, covering 877 beneficiaries. The average spend per beneficiary was $14,136.70.

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