Specialty Drug


TASIMELTEON is used to treat sleep-wake cycle disruptions in people who are blind. Compare melatonin receptor agonists.

Tasimelteon Medicare Coverage


Does Medicare cover Hetlioz?

100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Hetlioz co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Donut Hole
Post-Donut Hole
Co-Pay Range
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$3551 – $4687
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$15 – $710
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Tasimelteon

Here are some ways that may lower the cost of your Hetlioz prescription.

Fill a 90-Day Supply to Save
You may be able to lower your total cost by filling a greater quantity at one time.

Find Your Tasimelteon Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 30 capsules of Hetlioz 20mg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $3873
AARP MedicareComplete Plan 1 (HMO) $4065
AARP MedicareComplete SecureHorizons (HMO) $3752
AARP MedicareRx Preferred (PDP) $4541
AARP MedicareRx Saver Plus (PDP) $3551
Aetna Medicare Rx Saver (PDP) $3551
Cigna-HealthSpring Preferred (HMO) $4356
Cigna-HealthSpring Rx Secure (PDP) $3551
Cigna-HealthSpring Rx Secure-Extra (PDP) $3835
EnvisionRxPlus Silver (PDP) $3551
Express Scripts Medicare - Value (PDP) $3551
First Health Part D Value Plus (PDP) $4687
Humana Enhanced (PDP) $4687
Humana Preferred Rx Plan (PDP) $3551
Humana Walmart Rx Plan (PDP) $3551
Kaiser Permanente Senior Advantage (HMO) $4687
MedicareBlue Rx Standard (PDP) $3551
SilverScript Choice (PDP) $4653
Symphonix Value Rx (PDP) $3551
WellCare Classic (PDP) $3551
Don't see your Medicare plan above?

Find and configure your plan to see exact co-pay prices for your meds.

Tasimelteon Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Hetlioz that may include:

Quantity Limits

Most Medicare plans restrict the amount of this prescription that can be purchased at one time. If you need to purchase a greater amount at one time, it may not be covered. Your options are to wait until that time period has passed before refilling, call your plan and ask for an exception, or consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Hetlioz typically on?

Tier 5

Medicare plans typically list Hetlioz in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). If you encounter any issues, please let us know.
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