zolmitriptan 2.5 MG Oral Tablet [Zomig]
zolmitriptan
RxCUI: 153353
What the CMS Formulary Data Shows for zolmitriptan 2.5 MG Oral Tablet [Zomig]
Per the CMS 2026 Part D formulary file, zolmitriptan 2.5 MG Oral Tablet [Zomig] (RxNorm concept RXCUI 153353, generic name zolmitriptan) appears on 2 distinct formulary files spanning 20 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 2, with a cross-plan average of Tier 2.
Real-world access to zolmitriptan 2.5 MG Oral Tablet [Zomig] depends on utilization management as much as tier placement: 0% 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 11,158 Part D beneficiaries filled zolmitriptan 2.5 MG Oral Tablet [Zomig] in 2023, with total plan-and-beneficiary spending of $8,224,308 and an average per-beneficiary annual cost of $737.08. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry zolmitriptan 2.5 MG Oral Tablet [Zomig] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 20
- Coverage rate
- 0.4%
- Tier range
- Tier 2, Generic
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 11,158
- Total spending
- $8,224,308
- Avg per beneficiary
- $737.08
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering zolmitriptan 2.5 MG Oral Tablet [Zomig]
20 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T2 | No | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T2 | No | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T2 | No | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T2 | No | $0 | PA |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Dual Care Alliance (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $19.00 | ID |
| Geisinger Gold Value Rx (HMO) | GEISINGER HEALTH PLAN | T2 | No | $23.00 | PA |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $29.10 | OR |
| Geisinger Gold Classic Complete Rx (HMO) | GEISINGER HEALTH PLAN | T2 | No | $48.00 | PA |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $88.70 | OR |
| Geisinger Gold Classic Advantage Rx (HMO) | GEISINGER HEALTH PLAN | T2 | No | $99.30 | PA |
| PacificSource Medicare Essentials Rx 6 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $105.90 | OR |
| Geisinger Gold Preferred Advantage Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T2 | No | $112.00 | PA |
Frequently Asked Questions
Is zolmitriptan 2.5 MG Oral Tablet [Zomig] covered by Medicare Part D?
Yes, zolmitriptan 2.5 MG Oral Tablet [Zomig] is covered by 20 Medicare Part D plans (0.4% of all Part D formularies).
What tier is zolmitriptan 2.5 MG Oral Tablet [Zomig] on Medicare Part D plans?
zolmitriptan 2.5 MG Oral Tablet [Zomig] averages Tier 2 across Part D plans, ranging from Tier 2 to Tier 2.
Does zolmitriptan 2.5 MG Oral Tablet [Zomig] require prior authorization?
0% of Part D formularies require prior authorization for zolmitriptan 2.5 MG Oral Tablet [Zomig]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on zolmitriptan 2.5 MG Oral Tablet [Zomig]?
In 2023, total Medicare Part D spending on zolmitriptan 2.5 MG Oral Tablet [Zomig] was $8,224,308, covering 11,158 beneficiaries. The average spend per beneficiary was $737.08.
Read our methodology - how this data is sourced, computed, and verified.