Although
Ambien,
was covered by many Medicare Part D carriers in prior years, it is currently covered by
only a few Medicare Advantage plans (MAPD) and
no prescription drug plans (PDP).
Instead, Medicare plan providers more readily cover
Ambien's
generic equivalent,
Zolpidem Tartrate as a lower cost alternative.
You can use our Q1Rx
Drug Finder
tool to compare the Medicare Part D plan coverage for
Ambien,
Zolpidem Tartrate,
or any other medication.
Here are links to our Drug Finder showing examples of:
Remember, if
Zolpidem Tartrate
does not work for you and your Medicare plan does not cover
Ambien,
you can request a
formulary exception to have
Ambien
added to your formulary.
You will need support documentation from your prescribing
physician. If your formulary exception request is approved, the medication will most likely added as a specialty tier drug.
If your Medicare plan denies your formulary exception request, there are
5 levels of appeals
that your can go through to get coverage for your medication.
For more information, please also see our Frequently Asked Question:
What should I do if my prescription is not covered by my Medicare drug plan?
Here is an example screen of our
Q1Rx Drug Finder showing the two Medicare Advantage Special Needs Plans that cover Ambien in Queens County, New York. You can then change your location or medication to whatever you choose.
You can click on the average retail drug price (for example,
$611.21) to see how the average retail drug price has changed over time. You can also click on the Medicare plan name to see more details about the plan coverage.
See:
Ambien 10MG on Queens, New York MAPD plans