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Belsomra is a brand of suvorexant. What agents check before quoting it: how many 2027 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2027, 3,021 of 5,492 Medicare Part D and Medicare Advantage drug plans (55%) list Belsomra on their formulary, across 143 of 286 formularies. The most common placement is tier 3 (2,647 plans, 87.6% of those covering it). 154 of the covering plans require prior authorization (5.1%), 39 step therapy and 2,998 a quantity limit.
229 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $35, 57 of them $0; 2,792 charge coinsurance instead — median 21% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,400 in 2027, covered drugs cost $0 for the rest of the year.
2026: 3,156 of 5,496 plans covered it (57.4%); 2027: 3,021 of 5,492 (55%).
Of 4,367 plans offered in both years, 48 added it to the formulary and 25 dropped it.
Among plans covering it both years, 11 moved it to a higher tier and 401 to a lower one; 3 added prior authorization and 18 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 46 |
| Tier 2 | 276 |
| Tier 3 | 2,647 |
| Tier 4 | 52 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 287 of 323 | 88.9% | 0.7% |
| Medicare Advantage with drugs (MA-PD) | 1,663 of 3,200 | 52% | 7.2% |
| Special needs plans (SNP) | 1,071 of 1,969 | 54.4% | 3% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 0 of 631 | No tier listed | 0 |
| Wellcare | 268 of 268 | Tier 2 | 0 |
| HealthSpring | 226 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 0 of 80 | No tier listed | 0 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 63 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 8 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 27 of 27 | Tier 3 | 27 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 57 of 114 | 50% |
| Alaska | 8 of 9 | 88.9% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 86 of 147 | 58.5% |
| Arkansas | 53 of 85 | 62.4% |
| California | 167 of 397 | 42.1% |
| Colorado | 59 of 106 | 55.7% |
| Connecticut | 29 of 54 | 53.7% |
| Delaware | 27 of 43 | 62.8% |
| District of Columbia | 6 of 12 | 50% |
| Florida | 269 of 545 | 49.4% |
| Georgia | 97 of 149 | 65.1% |
| Guam | 1 of 1 | 100% |
| Hawaii | 20 of 50 | 40% |
| Idaho | 30 of 45 | 66.7% |
| Illinois | 78 of 132 | 59.1% |
| Indiana | 91 of 138 | 65.9% |
| Iowa | 38 of 64 | 59.4% |
| Kansas | 46 of 84 | 54.8% |
| Kentucky | 94 of 121 | 77.7% |
| Louisiana | 87 of 125 | 69.6% |
| Maine | 39 of 52 | 75% |
| Maryland | 19 of 49 | 38.8% |
| Massachusetts | 61 of 89 | 68.5% |
| Michigan | 46 of 182 | 25.3% |
| Minnesota | 40 of 63 | 63.5% |
| Mississippi | 74 of 104 | 71.2% |
| Missouri | 95 of 170 | 55.9% |
| Montana | 24 of 27 | 88.9% |
| Nebraska | 29 of 51 | 56.9% |
| Nevada | 73 of 100 | 73% |
| New Hampshire | 19 of 25 | 76% |
| New Jersey | 45 of 73 | 61.6% |
| New Mexico | 55 of 68 | 80.9% |
| New York | 104 of 215 | 48.4% |
| North Carolina | 103 of 176 | 58.5% |
| North Dakota | 22 of 26 | 84.6% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 104 of 171 | 60.8% |
| Oklahoma | 50 of 81 | 61.7% |
| Oregon | 53 of 92 | 57.6% |
| Pennsylvania | 93 of 323 | 28.8% |
| Puerto Rico | 47 of 64 | 73.4% |
| Rhode Island | 17 of 29 | 58.6% |
| South Carolina | 62 of 89 | 69.7% |
| South Dakota | 22 of 30 | 73.3% |
| Tennessee | 73 of 156 | 46.8% |
| Texas | 266 of 407 | 65.4% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 38 of 53 | 71.7% |
| Vermont | 12 of 14 | 85.7% |
| Virginia | 102 of 144 | 70.8% |
| Washington | 62 of 114 | 54.4% |
| West Virginia | 38 of 69 | 55.1% |
| Wisconsin | 71 of 96 | 74% |
| Wyoming | 10 of 13 | 76.9% |
Medicare Part D paid for 356,930 30-day fills of Belsomra in 2024 for about 77,066 enrollees, at an average total cost of $417.22 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Belsomra and the rest of a client's list on every plan in their county.
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Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 10/08/2026). CMS formulary data.