Drug Coverage Lookup
See how a prescription drug is placed across Medicare Part D plan formularies — tier, prior authorization, step therapy, and quantity limits, counted per unique plan.
Ambien (Zolpidem)
Non-Benzodiazepine Hypnotic (Z-Drug)
Found on the formularies of 5499 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 1570 plans (29%) · quantity limits on 5274 (96%), counting a plan when at least one form/strength carries the flag.
This is dataset-wide formulary placement (data current through 2026-08-31) — check your specific plan for its current coverage and restrictions.
| Plan | Tier | Prior Auth | Step Therapy | Qty Limit |
|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) | Tier 1 | No | No | 30 per 30 days |
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | Yes | No | 30 per 30 days |
| CCHP Senior Program (HMO) (H0571-001) (CA) | Tier 1 | No | No | 30 per 30 days |
| CCHP Senior Select Program (HMO D-SNP) (H0571-005) (CA) | Tier 1 | No | No | 30 per 30 days |
| CCHP Senior Value Program (HMO) (H0571-007) (CA) | Tier 1 | No | No | 30 per 30 days |
| CCHP Senior Program (HMO) (H0571-010) (CA) | Tier 1 | No | No | 30 per 30 days |
| CCHP Senior Value Program (HMO) (H0571-011) (CA) | Tier 1 | No | No | 30 per 30 days |
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | No | No | 30 per 30 days |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) | Tier 1 | Yes | No | 30 per 30 days |
| CCA One Care (HMO D-SNP) (H1486-001) (MA) | Tier 1 | Yes | No | 30 per 30 days |
| Gold Heart & Diabetes (HMO-POS C-SNP) (H1526-001) (FL) | Tiers 1–2 | No | No | 30 per 30 days |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) (H1526-002) (FL) | Tiers 1–2 | No | No | 30 per 30 days |
| Gold Dialysis & Kidney (HMO-POS C-SNP) (H1526-003) (FL) | Tiers 1–2 | No | No | 30 per 30 days |
| Gold Health (HMO-POS C-SNP) (H1526-008) (FL) | Tiers 1–2 | No | No | 30 per 30 days |
| Gold Dialysis & Kidney (HMO-POS C-SNP) (H1526-009) (FL) | Tiers 1–2 | No | No | 30 per 30 days |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001) (AR) | Tier 1 | No | No | 30 per 30 days |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | No | No | 30 per 30 days |
| Community Advantage Plus (HMO D-SNP) (H1671-001) (CA) | Tier 1 | No | No | 30 per 30 days |
| Astiva Health Savings Plan (HMO) (H1993-001) (CA) | Tier 1 | No | No | 30 per 30 days |
| Astiva Health C-SNP Deluxe (HMO C-SNP) (H1993-007) (CA) | Tier 1 | No | No | 30 per 30 days |
| Astiva Health Savings Plan - NorCal (HMO) (H1993-011) (CA) | Tier 1 | No | No | 30 per 30 days |
| Astiva Health Premier Plan - NorCal (HMO) (H1993-012) (CA) | Tier 1 | No | No | 30 per 30 days |
| Astiva Health Premier Plan (HMO) (H1993-015) (CA) | Tier 1 | No | No | 30 per 30 days |
| Community Care's Partnership Program (HMO D-SNP) (H2034-001) (WI) | Tier 1 | No | No | None |
| Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) | Tier 1 | Yes | No | 30 per 30 days |
One row per plan — showing 25 of 5499 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $5.20266/unit — price effective 08/19/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · NADAC price effective 08/19/2026 (per-NDC last change, not a data-staleness date). Dataset-wide plan-year formulary placement, not a guarantee of your individual benefit — confirm with your plan or pharmacist.
Data: CMS Monthly Part D formulary files · FDA/RxNorm drug identity · CMS NADAC pricing — CMS Part D formulary data current through 2026-08-31 · source
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=zolpidem