Is Ambien covered by any Medicare Part D plans?

Although Ambien, was covered by many Medicare Part D carriers in prior years, it is not currently covered by any Medicare Advantage plans (MAPD) or stand-alone prescription drug plans (PDP). This can change with each monthly formulary update, but Ambien has not been covered by any PDP plans in the last few years and only a few MAPD plans.

Instead, Medicare plan providers more readily cover Ambien's generic equivalent, Zolpidem Tartrate as a lower cost alternative.

You can use our the drug finder Drug Finder tool to compare the Medicare Part D plan coverage for 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 a 2024 example screen of our the drug finder Drug Finder showing the two Medicare Advantage Special Needs Plans that covered 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