Home › Agent Hub › Agent Tools › Part D coverage by drug › Zaleplon
Agent Tools
Zaleplon is a generic drug. 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, 3,879 of 5,492 Medicare Part D and Medicare Advantage drug plans (70.6%) list Zaleplon on their formulary, across 231 of 286 formularies. The most common placement is tier 3 (2,417 plans, 62.3% of those covering it). 767 of the covering plans require prior authorization (19.8%), 0 step therapy and 3,734 a quantity limit.
847 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 525 of them $0; 3,032 charge coinsurance instead — median 22% 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: 4,212 of 5,496 plans covered it (76.6%); 2027: 3,879 of 5,492 (70.6%).
Of 4,367 plans offered in both years, 15 added it to the formulary and 161 dropped it.
Among plans covering it both years, 58 moved it to a higher tier and 19 to a lower one; 8 added prior authorization and 21 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 226 |
| Tier 2 | 735 |
| Tier 3 | 2,417 |
| Tier 4 | 501 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 32 of 323 | 9.9% | 65.6% |
| Medicare Advantage with drugs (MA-PD) | 2,442 of 3,200 | 76.3% | 20.8% |
| Special needs plans (SNP) | 1,405 of 1,969 | 71.4% | 17% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 744 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 757 of 830 | Tier 3 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 631 of 631 | Tier 3 | 631 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 186 of 226 | Tier 4 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 2 | 0 |
| SCAN Health Plan | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 12 of 80 | Tier 2 | 12 |
| Alignment Health Plan | 77 of 77 | Tier 2 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 2 | 0 |
| Wellpoint | 63 of 63 | Tier 2 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 4 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 35 of 35 | Tier 2 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 4 | 0 |
| Medica | 27 of 27 | Tier 4 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 2 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 67 of 114 | 58.8% |
| Alaska | 1 of 9 | 11.1% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 91 of 147 | 61.9% |
| Arkansas | 59 of 85 | 69.4% |
| California | 298 of 397 | 75.1% |
| Colorado | 77 of 106 | 72.6% |
| Connecticut | 28 of 54 | 51.9% |
| Delaware | 24 of 43 | 55.8% |
| District of Columbia | 11 of 12 | 91.7% |
| Florida | 345 of 545 | 63.3% |
| Georgia | 112 of 149 | 75.2% |
| Guam | 0 of 1 | 0% |
| Hawaii | 19 of 50 | 38% |
| Idaho | 34 of 45 | 75.6% |
| Illinois | 84 of 132 | 63.6% |
| Indiana | 95 of 138 | 68.8% |
| Iowa | 41 of 64 | 64.1% |
| Kansas | 61 of 84 | 72.6% |
| Kentucky | 93 of 121 | 76.9% |
| Louisiana | 84 of 125 | 67.2% |
| Maine | 32 of 52 | 61.5% |
| Maryland | 27 of 49 | 55.1% |
| Massachusetts | 69 of 89 | 77.5% |
| Michigan | 141 of 182 | 77.5% |
| Minnesota | 55 of 63 | 87.3% |
| Mississippi | 67 of 104 | 64.4% |
| Missouri | 126 of 170 | 74.1% |
| Montana | 19 of 27 | 70.4% |
| Nebraska | 27 of 51 | 52.9% |
| Nevada | 86 of 100 | 86% |
| New Hampshire | 11 of 25 | 44% |
| New Jersey | 55 of 73 | 75.3% |
| New Mexico | 47 of 68 | 69.1% |
| New York | 143 of 215 | 66.5% |
| North Carolina | 126 of 176 | 71.6% |
| North Dakota | 18 of 26 | 69.2% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 123 of 171 | 71.9% |
| Oklahoma | 60 of 81 | 74.1% |
| Oregon | 48 of 92 | 52.2% |
| Pennsylvania | 220 of 323 | 68.1% |
| Puerto Rico | 61 of 64 | 95.3% |
| Rhode Island | 19 of 29 | 65.5% |
| South Carolina | 65 of 89 | 73% |
| South Dakota | 22 of 30 | 73.3% |
| Tennessee | 101 of 156 | 64.7% |
| Texas | 309 of 407 | 75.9% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 37 of 53 | 69.8% |
| Vermont | 4 of 14 | 28.6% |
| Virginia | 119 of 144 | 82.6% |
| Washington | 76 of 114 | 66.7% |
| West Virginia | 56 of 69 | 81.2% |
| Wisconsin | 81 of 96 | 84.4% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 213,361 30-day fills of Zaleplon in 2024 for about 49,756 enrollees, at an average total cost of $15.84 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Zaleplon and the rest of a client's list on every plan in their county.
Estimate Zaleplon costs by plan
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.