Medicare Part D coverage · temazepam · RxCUI 485489
temazepam 22.5 MG Oral Capsule
Per the CMS 2026 Part D formulary file, temazepam 22.5 MG Oral Capsule is covered by 1,083 Medicare Part D plans (21.4% of enrollable products), averaging Tier 2.3, with prior authorization required on 24.1% of covering formularies.
- 21.4%
- Plan coverage
- 1,083
- 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 1,083 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
- 1,083
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 1,083 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.
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
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
- suvorexant 10 MG Oral Tablet [Belsomra] 24.4% PA