MedicarePartD.guide

A non-government resource built from CMS public data

ZALEPLON 5 mg Capsule

Coverage in New York (CMS PDP Region 03).

3 of 10 stand-alone Part D plans in New York cover this drug on tier 3–4.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

159 Medicare Advantage plans in NY do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. NY: 159 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.6893$2.073 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible3Preferred Brand15%15%$0.2144$0.643 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible4Non-Preferred Drug38%—$0.2135$0.643 units
  • Quantity limit 3 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

See coverage in all 39 regions →