temazepam 22.5 MG Oral Capsule

Verify with CMS →

temazepam

RxCUI: 485489

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.
21.4%
Plan Coverage
1,084
Plans Covering
T2.3
Avg Tier
24.1%
Prior Auth Required

What the CMS Formulary Data Shows for temazepam 22.5 MG Oral Capsule

Per the CMS 2026 Part D formulary file, temazepam 22.5 MG Oral Capsule (RxNorm concept RXCUI 485489, generic name temazepam) appears on 87 distinct formulary files spanning 1,084 Medicare Part D plan offerings - 21.4% 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 2.3.

Real-world access to temazepam 22.5 MG Oral Capsule depends on utilization management as much as tier placement: 24.1% of covering formularies require prior authorization. 0% require step therapy. 87.4% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 394,771 Part D beneficiaries filled temazepam 22.5 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $30,183,894 and an average per-beneficiary annual cost of $76.46. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry temazepam 22.5 MG Oral Capsule today.

Coverage Details

Formularies covering
87
Plans covering
1,084
Coverage rate
21.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
24.1% of formularies
Step therapy required
0% of formularies
Quantity limits
87.4% of formularies

2023 Medicare Spending

Beneficiaries
394,771
Total spending
$30,183,894
Avg per beneficiary
$76.46

Tier Distribution Across Plans

31 plans
Tier 1, Preferred Generic
69 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering temazepam 22.5 MG Oral Capsule

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

Plan Insurer Tier PA Premium States
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
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
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
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
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
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
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
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
Tribute Select (HMO-POS I-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $8.90 AR
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
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
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
WV Senior Advantage (HMO I-SNP) WEST VIRGINIA SENIOR ADVANTAGE, INC. T1 No $32.70 WV
Abilis Health (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $35.90 KY, TN
CommuniCare Advantage ISNP (HMO I-SNP) OH CHS SNP INC. T1 No $38.40 IN, MD, OH
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T1 No $51.60 NY
Nascentia Skilled Nursing Facility (HMO I-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $58.80 NY
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediSun Full Dual Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediSun Full Dual Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 No $0 FL

Frequently Asked Questions

Is temazepam 22.5 MG Oral Capsule covered by Medicare Part D?

Yes, temazepam 22.5 MG Oral Capsule is covered by 1,084 Medicare Part D plans (21.4% of all Part D formularies).

What tier is temazepam 22.5 MG Oral Capsule on Medicare Part D plans?

temazepam 22.5 MG Oral Capsule averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does temazepam 22.5 MG Oral Capsule require prior authorization?

24.1% of Part D formularies require prior authorization for temazepam 22.5 MG Oral Capsule. Step therapy: 0%. Quantity limits: 87.4%.

How much does Medicare spend on temazepam 22.5 MG Oral Capsule?

In 2023, total Medicare Part D spending on temazepam 22.5 MG Oral Capsule was $30,183,894, covering 394,771 beneficiaries. The average spend per beneficiary was $76.46.

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