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Does Medicare Part D cover Belsomra?

Belsomra appears on the Medicare Part D formularies of 185 payers in the corpus, across 3,156 plans. 44 payers require prior authorization on every covering plan, 1 on some plans, and 140 on none.

Beyond prior authorization: 41 covering plans require step therapy (another drug tried first) and 3,131 apply a quantity limit, on at least one Belsomra product.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

PayerPlans coveringRequire prior authStep therapyQuantity limitStatus
Humana81700817No prior authorization
UnitedHealthcare73100731No prior authorization
Centene (WellCare)19700197No prior authorization
Cigna17100171No prior authorization
Blue Cross Blue Shield (affiliate)7328073Varies by plan
Elevance Health (Anthem)650065No prior authorization
Cariten Health Plan INC.440044No prior authorization
Uhc Of California400040No prior authorization
Careplus Health Plans, INC.360036No prior authorization
Bravo Health Pennsylvania, INC.350035No prior authorization
Preferred Care Partners, INC.350035No prior authorization
Medco Containment Life And Medco Containment Ny270027No prior authorization
Solis Health Plans, INC.2424024Prior authorization required
Sunshine State Health Plan, INC.240024No prior authorization
Physicians Health Choice Of Texas, LLC220022No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mmm Healthcare, LLC2002020No prior authorization
Mcs Advantage, INC.200020No prior authorization
Health Care Service Corporation1919019Prior authorization required
Harmony Health Plan, INC.190019No prior authorization
Medica Health Plans1717017Prior authorization required
Wellpoint Texas, INC.160016No prior authorization
Ultimate Health Plans, INC.160016No prior authorization
Excellus Health Plan, INC.160016No prior authorization
Medical Mutual Of Ohio1616016Prior authorization required
Superior Healthplan, INC.150015No prior authorization
Selecthealth, INC.1401414No prior authorization
Wellpoint Insurance Company140014No prior authorization
Peoples Health, INC.130013No prior authorization
Prominence Healthfirst Of Texas130013No prior authorization
Atrio Health Plans120012No prior authorization
HMO Louisiana, INC.1212012Prior authorization required
Hcsc Insurance Services Company1111011Prior authorization required
Aetna (CVS Health)100010No prior authorization
Community Insurance Company100010No prior authorization
HMO Colorado, INC.100010No prior authorization
Quartz Health Plan Corporation100010No prior authorization
Compcare Health Services Insurance Corporation100010No prior authorization
Sanford Health Plan9009No prior authorization
New York Quality Healthcare Corporation9009No prior authorization
Wellpoint Tennessee, INC.9009No prior authorization
Meridian Health Plan Of Michigan, INC.8008No prior authorization
American Progressive Life & Hlth Ins Company Of Ny8008No prior authorization
Keystone Health Plan East, INC.8008No prior authorization
Prominence Healthfirst8008No prior authorization
Fallon Community Health Plan8008No prior authorization
Wellpoint Health Plans, INC.7007No prior authorization
Astiva Health, INC.7007No prior authorization
Bravo Health Mid-Atlantic, INC.7007No prior authorization
Medica Insurance Company7707Prior authorization required
Summacare INC.7007No prior authorization
Champion Health Plan Of California INC7007No prior authorization
Essence Healthcare PPO, INC.7707Prior authorization required
Champion Health Plan Of Nevada, INC.7007No prior authorization
Bluecross And Blueshield Of South Carolina7007No prior authorization
Alterwood Advantage, INC.7007No prior authorization
Mass General Brigham Health Plan, INC6006No prior authorization
Buckeye Community Health Plan, INC.6006No prior authorization
Nebraska Total Care, INC.6006No prior authorization
Gold Kidney Of Florida INC6006No prior authorization
Essence Healthcare, INC.6606Prior authorization required
Hometown Health Plan, INC.6006No prior authorization
Presbyterian Health Plan6066No prior authorization
Preferred Care Network, INC.6006No prior authorization
Scott And White Health Plan6606Prior authorization required
Coordinated Care Of Washington, INC.5005No prior authorization
Chinese Community Health Plan5005No prior authorization
Independent Health Association, INC.5005No prior authorization
Coordinated Care Corporation5005No prior authorization
Oh Chs Snp INC.5005No prior authorization
Gold Kidney Of Arizona5005No prior authorization
Meridian Health Plan Of Illinois, INC.5005No prior authorization
Sunflower State Health Plan, INC.5005No prior authorization
Prominence Healthfirst Of Florida INC5005No prior authorization
Arkansas Health & Wellness Health Plan, INC.5005No prior authorization
Home State Health Plan, INC.4004No prior authorization
Baylor Scott & White Insurance Company4404Prior authorization required
Care N' Care Insurance Company Of North Carolina4004No prior authorization
Pennsylvania Health & Wellness, INC.4004No prior authorization
Sapphire Edge, INC.4404Prior authorization required
The Health Plan Of West Virginia, INC.4404Prior authorization required
Qcc Insurance Company4004No prior authorization
Leon Health, INC.4004No prior authorization
Verda Health Plan Of Texas INC4004No prior authorization
Security Health Plan Of Wisconsin, INC.4004No prior authorization
Boston Medical Center Health Plan, INC.4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4404Prior authorization required
Thp Insurance Company4404Prior authorization required
Amh Health, LLC4004No prior authorization
Quartz Health Plan Mn Corporation4004No prior authorization
Medisun, INC.3003No prior authorization
Wellpoint West Virginia , INC.3003No prior authorization
Louisiana Health Service & Indemnity Company3303Prior authorization required
Eternalhealth, INC.3003No prior authorization
Community Care Health Plan Of Louisiana, INC.3003No prior authorization
Village Senior Services Corporation3003No prior authorization
Trillium Community Health Plan, INC.3003No prior authorization
Baycare Select Health Plans, INC.3003No prior authorization
Cox Health Systems HMO INC3003No prior authorization
Wellpoint New Jersey, INC.3003No prior authorization
Capital District Physicians' Health Plan, INC.3003No prior authorization
Eternalhealth Of Arizona INC3003No prior authorization
Aultcare Health Insuring Corporation3003No prior authorization
Provider Partners Health Plan Of Pennsylvania, INC3003No prior authorization
Provider Partners Health Plan Of North Carolina3003No prior authorization
Provider Partners Health Plan Of Indiana3003No prior authorization
Celtic Insurance Company3003No prior authorization
Amerihealth Insurance Company Of New Jersey3003No prior authorization
Vns Choice3003No prior authorization
Mclaren Health Plan, INC.3003No prior authorization
Southeastern Indiana Health Organization, INC.3003No prior authorization
Central Mass Health, LLC3303Prior authorization required
Ghs Insurance Company3303Prior authorization required
Managed Health Services Insurance CORP.3003No prior authorization
Provider Partners Health Plan Of Missouri, INC.3003No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care3303Prior authorization required
Hamaspik, INC.2202Prior authorization required
Arizona Physicians Ipa, INC.2002No prior authorization
Ks Plan Administrators, LLC2002No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Beshp, INC.2002No prior authorization
Wellpoint Iowa, INC.2002No prior authorization
Wellpoint Washington, INC.2002No prior authorization
Signature Advantage, LLC2002No prior authorization
Primewest Rural Mn Health Care Access Initiative2002No prior authorization
Verda Health Plan Of Arizona, INC.2002No prior authorization
Sanford Health Plan Of Minnesota2002No prior authorization
Capital Advantage Insurance Company2202Prior authorization required
Keystone Health Plan Central, INC.2202Prior authorization required
Selectcare Of Texas, INC.2002No prior authorization
New Century Health Plan, INC.2002No prior authorization
Community Health Group2002No prior authorization
Banner - University Care Advantage2202Prior authorization required
Texas Independence Health Plan, INC.2002No prior authorization
Tufts Health Public Plans, INC.2000No prior authorization
Imperial Health Plan Of California, INC.2002No prior authorization
Bridgeway Health Solutions Of Arizona, INC.2002No prior authorization
Denver Health Medical Plan, INC.2002No prior authorization
Community Health Plan Of Washington2202Prior authorization required
Capital Health Plan2202Prior authorization required
Missouri Care, Incorporated2002No prior authorization
Elite Health Plan, INC.2002No prior authorization
Elderserve Health, INC.2202Prior authorization required
Good Samaritan Insurance Plan Of Nebraska, INC.2002No prior authorization
Excellus Health Plan Community Care LLC2002No prior authorization
Group Health Cooperative Of Eau Claire2202Prior authorization required
Caresource Georgia CO.2202Prior authorization required
Visiting Nurse Association Of Central New York2002No prior authorization
Longevity Health Plan Of New Jersey Insurance Comp2202Prior authorization required
Longevity Health Plan Of Colorado, INC.1101Prior authorization required
Tsg Guard, INC.1001No prior authorization
Longevity Health Plan Of Florida, INC.1101Prior authorization required
Imperial County Local Health Authority1001No prior authorization
Independent Care Health Plan1001No prior authorization
HMO Minnesota1101Prior authorization required
Wellpoint South Carolina, INC.1001No prior authorization
Upper Peninsula Health Plan, LLC1101Prior authorization required
Independent Health Benefits Corporation1001No prior authorization
Provider Partners Health Plan Of Illinois1001No prior authorization
Allcare Health Plan, INC.1001No prior authorization
Ghs Health Maintenance Organization, INC.1101Prior authorization required
Santa Clara County Health Authority1001No prior authorization
Provider Partners Health Plan Of Texas, INC.1001No prior authorization
Kern Health Systems1001No prior authorization
Hap Caresource1101Prior authorization required
Absolute Total Care, INC.1001No prior authorization
Longevity Health Plan Of North Carolina, INC.1101Prior authorization required
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1001No prior authorization
San Joaquin County Health Commission1001No prior authorization
Banner Health Plan, INC.1101Prior authorization required
Aids Healthcare Foundation1001No prior authorization
Alohacare1001No prior authorization
San Mateo Health Commission1001No prior authorization
Caresource Ohio, INC.1101Prior authorization required
Provider Partners Health Plan Of Kentucky1001No prior authorization
Longevity Health Plan Of Michigan, INC.1101Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1001No prior authorization
Longevity Health Plan Of New York, INC.1101Prior authorization required
Healthy Mississippi, INC.1011No prior authorization
Inland Empire Health Plan1001No prior authorization
West Virginia Senior Advantage, INC.1001No prior authorization
Longevity Health Plan Of Illinois, INC.1101Prior authorization required
Ventura County Medi-Cal Managed Care Commission1101Prior authorization required
Horizon Insurance Company1101Prior authorization required

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Belsomra product on its formulary carries that condition.

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.