Medicare Part D coverage · ziprasidone · RxCUI 284550

ziprasidone 80 MG Oral Capsule [Geodon]

Per the CMS 2026 Part D formulary file, ziprasidone 80 MG Oral Capsule [Geodon] is covered by 2 Medicare Part D plans (0% of enrollable products), averaging Tier 1, with prior authorization required on 100% of covering formularies.

0%
Plan coverage
2
Plans covering
T1
Avg tier
100%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for ziprasidone 80 MG Oral Capsule [Geodon]

Per the CMS 2026 Part D formulary file, ziprasidone 80 MG Oral Capsule [Geodon] (RxNorm concept RXCUI 284550, generic name ziprasidone) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to ziprasidone 80 MG Oral Capsule [Geodon] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 82,972 Part D beneficiaries filled ziprasidone 80 MG Oral Capsule [Geodon] in 2023, with total plan-and-beneficiary spending of $57,099,875 and an average per-beneficiary annual cost of $688.18. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ziprasidone 80 MG Oral Capsule [Geodon] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
82,972
Total spending
$57,099,875
Avg per beneficiary
$688.18

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering ziprasidone 80 MG Oral Capsule [Geodon]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 Yes $0 NY
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 Yes $34.50 NY

Frequently Asked Questions

Is ziprasidone 80 MG Oral Capsule [Geodon] covered by Medicare Part D?

Yes, ziprasidone 80 MG Oral Capsule [Geodon] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is ziprasidone 80 MG Oral Capsule [Geodon] on Medicare Part D plans?

ziprasidone 80 MG Oral Capsule [Geodon] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does ziprasidone 80 MG Oral Capsule [Geodon] require prior authorization?

100% of Part D formularies require prior authorization for ziprasidone 80 MG Oral Capsule [Geodon]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on ziprasidone 80 MG Oral Capsule [Geodon]?

In 2023, total Medicare Part D spending on ziprasidone 80 MG Oral Capsule [Geodon] was $57,099,875, covering 82,972 beneficiaries. The average spend per beneficiary was $688.18.

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

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