zolpidem tartrate 3.5 MG Sublingual Tablet
zolpidem tartrate
RxCUI: 1232202
What the CMS Formulary Data Shows for zolpidem tartrate 3.5 MG Sublingual Tablet
Per the CMS 2026 Part D formulary file, zolpidem tartrate 3.5 MG Sublingual Tablet (RxNorm concept RXCUI 1232202, generic name zolpidem tartrate) appears on 5 distinct formulary files spanning 43 Medicare Part D plan offerings - 0.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to zolpidem tartrate 3.5 MG Sublingual Tablet depends on utilization management as much as tier placement: 20% 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 1,435,449 Part D beneficiaries filled zolpidem tartrate 3.5 MG Sublingual Tablet in 2023, with total plan-and-beneficiary spending of $60,779,002 and an average per-beneficiary annual cost of $42.34. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry zolpidem tartrate 3.5 MG Sublingual Tablet today.
Coverage Details
- Formularies covering
- 5
- Plans covering
- 43
- Coverage rate
- 0.8%
- Tier range
- Tier 3 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 20% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,435,449
- Total spending
- $60,779,002
- Avg per beneficiary
- $42.34
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering zolpidem tartrate 3.5 MG Sublingual Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T3 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T3 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering zolpidem tartrate 3.5 MG Sublingual Tablet
41 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T3 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T3 | No | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T3 | No | $0 | NY |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $36.90 | NY |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $51.00 | NY |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T3 | Yes | $51.80 | PA |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $58.60 | NY |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $86.40 | NY |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T3 | Yes | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $98.20 | PA |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T3 | No | $100.00 | NY |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $122.40 | PA |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T3 | No | $135.00 | NY |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | Yes | $145.40 | PA |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T3 | No | $146.00 | NY |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Dual Care Alliance (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $19.00 | ID |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $29.10 | OR |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $88.70 | OR |
| PacificSource Medicare Essentials Rx 6 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $105.90 | OR |
Frequently Asked Questions
Is zolpidem tartrate 3.5 MG Sublingual Tablet covered by Medicare Part D?
Yes, zolpidem tartrate 3.5 MG Sublingual Tablet is covered by 43 Medicare Part D plans (0.8% of all Part D formularies).
What tier is zolpidem tartrate 3.5 MG Sublingual Tablet on Medicare Part D plans?
zolpidem tartrate 3.5 MG Sublingual Tablet averages Tier 3.2 across Part D plans, ranging from Tier 3 to Tier 4.
Does zolpidem tartrate 3.5 MG Sublingual Tablet require prior authorization?
20% of Part D formularies require prior authorization for zolpidem tartrate 3.5 MG Sublingual Tablet. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on zolpidem tartrate 3.5 MG Sublingual Tablet?
In 2023, total Medicare Part D spending on zolpidem tartrate 3.5 MG Sublingual Tablet was $60,779,002, covering 1,435,449 beneficiaries. The average spend per beneficiary was $42.34.
Read our methodology - how this data is sourced, computed, and verified.