Medicare Part D coverage · suvorexant · RxCUI 1547118
suvorexant 20 MG Oral Tablet [Belsomra]
Per the CMS 2026 Part D formulary file, suvorexant 20 MG Oral Tablet [Belsomra] is covered by 2,934 Medicare Part D plans (58.1% of enrollable products), averaging Tier 2.7, with prior authorization required on 24.4% of covering formularies.
- 58.1%
- Plan coverage
- 2,934
- Plans covering
- T2.7
- Avg tier
- 24.4%
- Prior auth required
What the CMS Formulary Data Shows for suvorexant 20 MG Oral Tablet [Belsomra]
Per the CMS 2026 Part D formulary file, suvorexant 20 MG Oral Tablet [Belsomra] (RxNorm concept RXCUI 1547118, generic name suvorexant) appears on 160 distinct formulary files spanning 2,934 Medicare Part D plan offerings - 58.1% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to suvorexant 20 MG Oral Tablet [Belsomra] depends on utilization management as much as tier placement: 24.4% of covering formularies require prior authorization. 2.5% require step therapy. 96.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 86,387 Part D beneficiaries filled suvorexant 20 MG Oral Tablet [Belsomra] in 2023, with total plan-and-beneficiary spending of $161,202,978 and an average per-beneficiary annual cost of $1,866.06. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry suvorexant 20 MG Oral Tablet [Belsomra] today.
Coverage Details
- Formularies covering
- 160
- Plans covering
- 2,934
- Coverage rate
- 58.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 24.4% of formularies
- Step therapy required
- 2.5% of formularies
- Quantity limits
- 96.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 86,387
- Total spending
- $161,202,978
- Avg per beneficiary
- $1,866.06
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering suvorexant 20 MG Oral Tablet [Belsomra]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering suvorexant 20 MG Oral Tablet [Belsomra]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
Show the next 30 plans
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | Yes | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | Yes | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | Yes | $35.20 | CO |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is suvorexant 20 MG Oral Tablet [Belsomra] covered by Medicare Part D?
Yes, suvorexant 20 MG Oral Tablet [Belsomra] is covered by 2,934 Medicare Part D plans (58.1% of all Part D formularies).
What tier is suvorexant 20 MG Oral Tablet [Belsomra] on Medicare Part D plans?
suvorexant 20 MG Oral Tablet [Belsomra] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does suvorexant 20 MG Oral Tablet [Belsomra] require prior authorization?
24.4% of Part D formularies require prior authorization for suvorexant 20 MG Oral Tablet [Belsomra]. Step therapy: 2.5%. Quantity limits: 96.9%.
How much does Medicare spend on suvorexant 20 MG Oral Tablet [Belsomra]?
In 2023, total Medicare Part D spending on suvorexant 20 MG Oral Tablet [Belsomra] was $161,202,978, covering 86,387 beneficiaries. The average spend per beneficiary was $1,866.06.
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
- cyclosporine, modified 25 MG Oral Capsule T2.7
- insulin aspart, human 100 UNT/ML Injectable Solution [NovoLog] T2.7
- insulin glargine 100 UNT/ML Injectable Solution [Lantus] T2.7
- theophylline 450 MG Extended Release Oral Tablet T2.7
- 24 HR amphetamine aspartate 1.25 MG / amphetamine sulfate 1.25 MG / dextroamphetamine saccharate 1.25 MG / dextroamphetamine sulfate 1.25 MG Extended Release Oral Capsule T2.7
- ampicillin 1000 MG / sulbactam 500 MG Injection T2.7
Similar prior-authorization rate
- toremifene 60 MG Oral Tablet 24.4% PA
- aripiprazole 10 MG Disintegrating Oral Tablet 24.4% PA
- aripiprazole 15 MG Disintegrating Oral Tablet 24.4% PA
- doxercalciferol 0.001 MG Oral Capsule 24.4% PA
- doxercalciferol 0.0025 MG Oral Capsule 24.4% PA
- temazepam 22.5 MG Oral Capsule 24.1% PA