Ambien

Generic: Zolpidem

5MG, 10MG — Tablet

Also known as: AMBIEN TABS 5MG, 10MG

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	—	—	✓	QL

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026	Tier 1 - Lowest Cost Generic	—	—	—	None

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Zolpidem	Non-Preferred	—	—	—	None

3 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 3 - Non-Preferred Brand	✓	—	✓	PA \| QL
NC State Health Plan - 70/30 Standard PPO 2026	Tier 3 - Non-Preferred Brand	✓	—	✓	PA \| QL
NC State Health Plan - HDHP 2026	Tier 3 - Non-Preferred Brand	✓	—	✓	PA \| QL