Does Medicaid cover Trazodone in Florida?

If you’re struggling with insomnia and considering medication, you’ve likely heard about trazodone or doxepin as potential treatment options. These medications have become go-to alternatives for sleep problems, particularly when controlled substances aren’t appropriate or preferred. But one critical question remains: will your insurance actually cover them?

The good news: unlike many newer sleep medications that face strict insurance hurdles, trazodone and doxepin generics enjoy remarkably broad coverage across commercial insurance, Medicare, and Medicaid plans. In this comprehensive guide, we’ll walk you through exactly what to expect when filling these prescriptions—from insurance approval to out-of-pocket costs.

Understanding Trazodone and Doxepin for Insomnia

Before diving into insurance specifics, it’s helpful to understand what these medications are and why they’re commonly prescribed for sleep.

Trazodone is technically an antidepressant, but it’s frequently prescribed off-label for insomnia at lower doses (typically 25-100 mg at bedtime). Its sedating properties make it effective for helping people fall asleep, and because it’s non-controlled, prescribers often favor it as a first-line option. The brand name Desyrel has been discontinued, so you’ll only encounter the generic version today.

Doxepin is a tricyclic antidepressant that also has strong sedative effects. At very low doses (3-6 mg), it’s FDA-approved specifically for insomnia under the brand name Silenor. At higher doses (10 mg and up), generic doxepin is available as an antidepressant but is sometimes prescribed off-label for sleep as well.

Both medications work differently than common ‘sleeping pills’ like Ambien (zolpidem) or Lunesta (eszopiclone). They’re not controlled substances, which means fewer regulatory restrictions and typically easier insurance approval.

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Commercial Insurance Coverage: What Most Plans Cover

If you have employer-sponsored health insurance or a plan from the ACA marketplace, chances are excellent that trazodone and generic doxepin are covered without major obstacles.

Coverage Status Across Major Insurers

Nearly all commercial insurance formularies include generic trazodone as a Tier 1 medication. This is the most favorable tier, typically associated with the lowest copays—often just $5-$10 for a 30-day supply. Major insurers like UnitedHealthcare, Aetna, Cigna, Humana, and Ambetter (Centene) all list trazodone as a preferred generic drug.

Generic doxepin (capsules at standard strengths like 10 mg, 25 mg, or 50 mg) is similarly well-covered, also appearing as a Tier 1 generic on most formularies. The situation differs, however, for the brand-name Silenor (low-dose doxepin specifically marketed for insomnia). Most insurance plans either don’t cover Silenor at all or place it in Tier 3 or 4 (non-preferred brand), requiring substantially higher copays and often prior authorization.

Prior Authorization Requirements

Here’s where trazodone and doxepin really shine from an access standpoint: most plans require no prior authorization for the generic versions. You won’t need to jump through hoops proving you’ve tried other medications first or documenting treatment failures.

This is a significant advantage compared to controlled sleep medications. For instance, if your doctor prescribes generic zolpidem ER (extended-release Ambien) or Lunesta, many insurers require documentation that you’ve tried and failed standard immediate-release options first—a process called step therapy. With trazodone and generic doxepin, that barrier simply doesn’t exist in most cases.

The exception? If your provider writes a prescription for brand-name Silenor instead of generic doxepin, the insurance company will almost certainly require prior authorization. The insurer will want documentation explaining why the generic won’t work for you—perhaps an allergy to inactive ingredients or a specific dosing need. Without this justification, the claim will likely be denied.

Typical Out-of-Pocket Costs with Insurance

With commercial insurance coverage, your copay for a 30-day supply of generic trazodone or doxepin typically falls between:

• Tier 1 copay: $0-$15 (most common)
• Tier 2 copay: $15-$35 (some plans)
• Deductible applies: If you haven’t met your annual deductible, you might pay the full negotiated rate (usually still quite low, around $10-$20)

If your plan covers Silenor brand with prior approval, expect significantly higher costs—potentially $50-$100+ copay for Tier 3/4 brands, or a percentage coinsurance that could run into hundreds of dollars.

Medicare Part D and Medicare Advantage Coverage

For those 65 and older or eligible for Medicare through disability, both trazodone and doxepin generics are covered under virtually all Medicare Part D prescription drug plans.

Medicare Formulary Placement

Medicare plans nearly universally place generic trazodone in Tier 1, meaning beneficiaries typically pay just a few dollars per month—often $0-$10 copay during the initial coverage period. The same applies to generic doxepin capsules.

Medicare Advantage plans (Part C) that include prescription coverage follow similar patterns, with these medications appearing as preferred generics on their formularies.

No Prior Authorization Hurdles

Just like commercial insurance, Medicare Part D plans typically do not require prior authorization for generic trazodone or doxepin. This makes these medications particularly accessible for older adults dealing with insomnia—a demographic where sleep problems are common and providers often prefer non-controlled options due to safety concerns with sedative-hypnotics in elderly patients.

Medicaid Coverage: State-by-State Breakdown

Medicaid coverage varies by state, but trazodone and doxepin generics enjoy remarkably consistent coverage across the country. We’ve verified coverage in six major states representing diverse Medicaid populations:

California (Medi-Cal)

Status: Covered without prior authorization
Trazodone appears on the Medi-Cal Rx Contract Drugs List with no special restrictions. Standard quantity limits apply (typically one dose per day), but no PA is required. Generic doxepin is similarly covered.

Texas Medicaid

Status: Preferred drug, no prior authorization
The Texas Health and Human Services Commission lists trazodone as a preferred medication on the Vendor Drug Program Preferred Drug List, meaning it’s readily accessible without step therapy or PA requirements.

Florida Medicaid

Status: Covered, no prior authorization
Florida’s Agency for Health Care Administration includes trazodone as a preferred generic on the state Preferred Drug List. Coverage is straightforward with no unusual restrictions.

New York Medicaid

Status: Covered on both fee-for-service and managed care formularies
New York Medicaid covers trazodone without prior authorization, treating it as a standard formulary generic. Any utilization management is minimal, limited to basic safety edits.

Pennsylvania Medical Assistance

Status: Preferred drug on statewide PDL
Pennsylvania’s Medicaid program marks generic trazodone as preferred as of 2025, with no PA required and standard quantity limits of approximately 30 tablets per 30 days.

Illinois Medicaid

Status: Covered, no prior authorization
Illinois Medicaid includes trazodone on its formulary as a covered generic. While the state’s prior authorization database temporarily paused updates due to a 2024 cybersecurity incident, coverage for these long-established generics remained consistent.

Key Medicaid Takeaway

Across all major state Medicaid programs, trazodone and generic doxepin are covered without prior authorization. The most you’ll typically encounter is standard quantity limits (usually 30 tablets per month) that align with normal prescribing practices. This makes these medications excellent options for Medicaid beneficiaries struggling with insomnia, especially since controlled sleep aids often do require PA in Medicaid programs.

What About Brand Names? The Silenor Situation

While generic trazodone and doxepin sail through insurance approval, brand-name Silenor faces much tighter restrictions.

Silenor is FDA-approved specifically for insomnia at 3 mg and 6 mg doses—lower than typical antidepressant doses of doxepin. However, because generic low-dose doxepin has become available, most insurance plans either:

1. Don’t cover Silenor at all (excluded from formulary)
2. Place it in non-preferred tiers (Tier 3 or 4) with high copays
3. Require prior authorization demonstrating medical necessity and failure of generic alternatives

If your doctor believes you need the specific low-dose formulation of Silenor rather than generic doxepin, be prepared to work through a prior authorization process. You’ll need documentation explaining why the generic doesn’t meet your needs—perhaps you’ve tried generic doxepin at low doses and experienced side effects from inactive ingredients, or you need a dose that isn’t available in generic form.

The reality: many insurers will simply encourage using generic doxepin capsules (which can be taken at lower doses under medical supervision) rather than covering the brand-name Silenor. From a cost perspective, this makes sense for both insurers and patients.

Prior Authorization Explained: When and How It Works

While trazodone and doxepin generics typically don’t require prior authorization, understanding the PA process is valuable—especially if you’re prescribed other sleep medications or the brand-name Silenor.

What Is Prior Authorization?

Prior authorization (PA) is an approval process where your doctor must prove to your insurance company that a prescribed medication is medically necessary before the insurer will cover it. It’s a utilization management tool insurers use to control costs and ensure appropriate prescribing.

When PA Is Required for Sleep Medications

For controlled insomnia medications like zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata), many insurance plans require:

• Diagnosis documentation: An ICD-10 code confirming chronic insomnia
• Treatment history: Evidence of prior medications tried
• Step therapy compliance: Proof you’ve tried preferred alternatives first
• Clinical rationale: Explanation of why this specific medication is necessary

For example, if your doctor prescribes extended-release zolpidem (Ambien CR), the insurance might require documentation that you tried immediate-release zolpidem first. If you’re prescribed brand-name Silenor, they’ll want to know why generic doxepin won’t work.

Documentation Required

A complete prior authorization request typically includes:

• Patient information and insurance details
• Diagnosis with ICD-10 code(s)
• Medication name, strength, and quantity
• Clinical notes justifying medical necessity
• Documentation of previous treatments and outcomes
• Any contraindications to preferred alternatives

For elderly patients (65+), insurers may require additional justification due to the Beers Criteria—a list of medications potentially inappropriate for older adults. Interestingly, low-dose doxepin is actually one of the few sedatives that’s considered safer for seniors, sometimes giving it an advantage in PA approval.

Approval Timeline

Most commercial insurance plans process prior authorization requests within 24-72 hours for standard requests. Urgent requests can be expedited, sometimes approved within hours. Medicaid plans typically take 1-3 business days.

Telehealth providers like Klarity Health often submit PAs electronically, which can speed up the process compared to traditional fax submissions.

Common Denial Reasons

If a PA is denied, it’s usually for one of these reasons:

1. Step therapy not met: You haven’t tried the required first-line medication(s)
2. Insufficient documentation: Missing clinical notes or treatment history
3. Formulary issues: The drug isn’t covered at all, and a covered alternative exists
4. Dosing concerns: Prescribed quantity exceeds plan limits
5. Duplicate therapy: You’re already taking another medication in the same class

For trazodone and doxepin generics, denials are rare. The most common scenario is when the brand is requested instead of the generic—easily resolved by switching to the generic formulation.

Appeal Success Rates

If your PA is denied, you have the right to appeal. Appeals are often successful when additional information or clarification is provided. For instance, if your request for Ambien CR was denied for not trying regular Ambien first, an appeal letter documenting your trial of generic zolpidem IR (and why it didn’t work) will frequently result in approval.

The key to a successful appeal:

• Provide thorough clinical documentation
• Address the specific reason for denial
• Include any relevant medical records or test results
• Follow up regularly on the appeal status

Insurers must respond to appeals within specific timeframes—typically 30 days for standard appeals, 72 hours for expedited appeals. Persistence pays off: with complete documentation and a valid medical rationale, many initially denied requests are ultimately approved.

Self-Pay Options: Surprisingly Affordable

Not everyone has insurance, and some prefer to pay cash for privacy or other reasons. The excellent news about trazodone and doxepin: they’re remarkably affordable out-of-pocket.

Trazodone Cash Prices

Without insurance, you can expect to pay:

• Retail price: Approximately $15 for 30 tablets (50 mg)
• With GoodRx or similar discount: Around $4-$7 for 30 tablets
• Per-pill cost: Less than $0.50 each at retail, sometimes under $0.15 with coupons

The brand name Desyrel is no longer marketed, so you’re only dealing with generic pricing—which works in your favor.

Doxepin Cash Prices

Generic doxepin is similarly inexpensive:

• Generic capsules (10 mg, 25 mg, 50 mg): $13-$20 for 30 capsules retail
• With pharmacy discount programs: $2-$5 for 30 capsules
• Per-pill cost: Approximately $0.45 at retail, as low as $0.10 with discounts

However, brand-name Silenor tells a very different story:

• Silenor (3 mg or 6 mg): $500+ for 30 tablets
• Limited discount availability (previous manufacturer coupons ended in 2023)

If you need the low-dose formulation specifically for insomnia and don’t have insurance coverage, discuss with your doctor whether generic doxepin at a lower dose might work as an alternative. Many patients find that generic 10 mg doxepin capsules (which can sometimes be split or taken at lower frequency under medical guidance) provide similar benefits at a fraction of the cost.

Discount Programs to Consider

Several programs can reduce your out-of-pocket costs even further:

GoodRx: The most popular prescription discount service, offering coupons that can reduce generic trazodone to around $4 and generic doxepin to $2-$5 for a month’s supply.

Pharmacy discount programs: Many chain pharmacies (CVS, Walgreens, Walmart) offer their own discount programs, sometimes featuring these generics on ‘$4 lists’ for common prescriptions.

Manufacturer programs: Not applicable for these generics due to their already-low cost (and Silenor’s previous copay card program ended in 2023).

Patient assistance programs: Given the minimal cost of generics, formal patient assistance programs are uncommon. However, some charitable pharmacies and clinics can provide these medications at no or very low cost to patients with financial hardship.

The Bottom Line on Self-Pay

For people without insurance or those who prefer cash payment, trazodone and generic doxepin represent some of the most affordable prescription sleep aid options available. At under $10 per month with discount coupons, they’re more accessible than many over-the-counter sleep supplements—and often more effective.

This affordability makes these medications particularly attractive for telehealth prescribing. Providers like Klarity Health can prescribe trazodone or doxepin knowing that patients can actually afford to fill the prescription, whether they’re using insurance or paying cash.

Comparing Insurance Coverage: Trazodone/Doxepin vs. Other Sleep Medications

To put the insurance landscape in perspective, let’s compare how trazodone and doxepin stack up against other common insomnia treatments:

As you can see, generic trazodone and doxepin offer the easiest insurance access among prescription sleep medications. They rarely require prior authorization, don’t involve step therapy, sit in the most favorable formulary tier, and come with the lowest copays.

This matters enormously in real-world practice. When a patient contacts their doctor about sleep problems, getting a prescription is only half the battle—they also need to fill it. Medications that require extensive PA documentation or that get denied can leave patients waiting days or weeks for treatment (or giving up entirely).

Real-World Scenarios: What to Expect

Let’s walk through some common situations to see how insurance coverage plays out in practice:

Scenario 1: Commercial Insurance Patient

Situation: Sarah, 42, has employer-sponsored insurance through Aetna. She’s been struggling with insomnia and sees her primary care doctor, who prescribes trazodone 50 mg at bedtime.

What happens: Sarah takes her prescription to CVS. The pharmacy submits the claim to Aetna, which approves it immediately (no PA required). Her copay is $5 for a 30-day supply. She picks up the medication the same day.

Takeaway: Smooth sailing with generic trazodone on commercial insurance.

Scenario 2: Medicare Part D Patient

Situation: Robert, 68, has Medicare Part D through Humana. His doctor recommends doxepin for insomnia and prescribes generic doxepin 10 mg capsules.

What happens: Robert fills the prescription at Walgreens. His Part D plan covers generic doxepin as a Tier 1 medication with a $0 copay (he’s in the initial coverage period). No authorization is needed.

Takeaway: Excellent Medicare coverage for generic doxepin.

Scenario 3: Medicaid Patient in Texas

Situation: Maria receives Texas Medicaid benefits. She’s experiencing chronic insomnia and gets a trazodone prescription from a telehealth provider through Klarity Health.

What happens: Maria fills her prescription at her local pharmacy. Texas Medicaid covers trazodone as a preferred drug with no prior authorization. Her copay is minimal (many Medicaid plans have $0-$3 copays for generic medications). She receives her medication without delays.

Takeaway: Medicaid coverage works seamlessly for trazodone.

Scenario 4: Brand Name Request

Situation: Jennifer, 55, has Blue Cross Blue Shield insurance. Her doctor wants to try Silenor (brand-name low-dose doxepin) instead of generic because she’s sensitive to medications and the doctor believes the specific 3 mg dose will work best.

What happens: The pharmacy submits the claim for Silenor, which is denied—the medication isn’t on the formulary, and the plan requires trying generic doxepin first. Jennifer’s doctor submits a prior authorization explaining why the specific low dose is needed and documenting Jennifer’s medication sensitivities. After three days, the PA is approved with a note that Jennifer must try generic doxepin 10 mg (at partial dose or less frequent administration) for 30 days first. If that fails, Silenor will be covered at Tier 3 with a $60 copay.

Takeaway: Brand names face hurdles even with PA, often requiring step therapy.

Scenario 5: Cash Pay Patient

Situation: David doesn’t have health insurance and schedules a telehealth appointment through Klarity Health for insomnia. The provider prescribes trazodone 50 mg.

What happens: David uses a GoodRx coupon and pays $6 for a 30-day supply at his local pharmacy. He’s surprised at how affordable it is and continues treatment.

Takeaway: Excellent cash-pay affordability for uninsured patients.

Klarity Health: Streamlined Access to Sleep Medication

When dealing with insomnia, timely access to treatment matters. That’s where telehealth providers like Klarity Health offer significant advantages in navigating the insurance landscape.

Provider Availability

Klarity Health offers appointments seven days a week, including evenings, making it convenient to get care when you need it—not weeks from now. Many patients can see a provider within 24-48 hours, sometimes sooner.

This accessibility is particularly valuable when you’re struggling with sleep and need help quickly. Traditional in-office appointments might require waiting two to three weeks, leaving you to struggle with insomnia in the meantime.

Transparent Pricing

Klarity Health provides clear, upfront pricing for both appointments and prescriptions. You’ll know the cost of your visit before you book, and providers can discuss medication costs (both with insurance and cash-pay) during your appointment.

This transparency extends to insurance coverage. Klarity accepts many insurance plans, and you can verify coverage before your appointment. For those without insurance or who prefer cash payment, self-pay rates are clearly posted—no surprise bills.

Insurance and Cash Pay Flexibility

Insurance accepted: Klarity Health works with many major insurance carriers, billing your visit like any other medical appointment. If your plan covers telehealth mental health services, your Klarity visit is typically covered (subject to your copay or deductible).

Cash pay option: For those without insurance or who prefer not to use it, Klarity offers straightforward cash-pay pricing. This can be particularly attractive if you have a high-deductible plan and haven’t met your deductible yet.

The medication itself—whether trazodone or doxepin—remains affordable either way, as we’ve discussed.

Prescription Process

After your evaluation, if the provider determines that trazodone or doxepin is appropriate for your insomnia, they can send the prescription electronically to your preferred pharmacy. Because these medications rarely require prior authorization, you can typically pick up your prescription the same day or next day.

If any insurance issues do arise (which is uncommon with these generics), Klarity’s care team can work with you to resolve them—whether that means submitting a PA, switching to a different medication, or helping you find the most affordable cash-pay option.

Follow-Up Care

Sleep medication often requires adjustment and monitoring. Klarity makes follow-up appointments easy to schedule, and because everything is telehealth, you don’t need to take time off work or arrange transportation. This continuity of care helps ensure your treatment remains effective and covered by insurance.

When Insurance Says No: Your Next Steps

Despite the generally excellent coverage for trazodone and doxepin, occasional issues can arise. Here’s what to do if you encounter resistance:

Step 1: Verify the Problem

First, make sure you understand exactly why the claim was denied:

• Was the prescription written for brand name instead of generic?
• Is there a coverage exclusion you weren’t aware of?
• Did the pharmacy submit it correctly?
• Is there a quantity limit issue (e.g., prescription written for 60 tablets, but plan limits to 30)?

Sometimes what seems like a denial is actually a pharmacy error or a simple fix like switching from brand to generic.

Step 2: Try a Different Pharmacy

If one pharmacy shows the medication as ‘not covered,’ try another. Different pharmacies contract differently with insurance plans, and occasionally a medication flagged at one pharmacy goes through smoothly at another.

Also, check whether your insurance has a preferred pharmacy network with lower copays.

Step 3: Request Prior Authorization

If prior authorization is genuinely required (most common for brand Silenor or if you’re prescribed an unusually high dose), work with your doctor’s office to submit the necessary documentation.

Be proactive: follow up after 2-3 days to check the status. Many PAs are approved once complete information is submitted.

Step 4: File an Appeal

If your PA is denied and you believe the denial was inappropriate, file a formal appeal. Include:

• A letter from your doctor explaining medical necessity
• Documentation of previous treatments tried and failed
• Any relevant medical records
• Specific responses to the denial reasons

Your insurance company must provide information about the appeals process in their denial letter.

Step 5: Consider Cash Pay

Given how affordable generic trazodone and doxepin are, it might actually cost less to pay cash (especially with a discount coupon) than to navigate a complicated insurance issue—particularly if you have a high deductible.

For example, if your deductible is $2,000 and you haven’t met it, your ‘covered’ medication might still cost you $20-$30 out of pocket. In that case, using a $4 GoodRx coupon for trazodone saves you money and hassle.

Step 6: Alternative Medications

If insurance truly won’t cover your prescribed medication and cash pay isn’t feasible for some reason, discuss alternatives with your provider:

• If denied for doxepin, try trazodone instead (or vice versa)
• If denied for a brand, switch to the generic equivalent
• Consider other formulary-preferred options your plan does cover

Most insurers have clear formulary lists available online or through customer service, showing exactly which sleep medications are covered and at what tier.

Frequently Asked Questions

Does insurance usually require prior authorization for trazodone or doxepin for insomnia?

No, prior authorization is typically not required for generic trazodone or generic doxepin. These are Tier 1 generics on most commercial, Medicare, and Medicaid formularies, covered without extensive approval processes. Brand-name Silenor (low-dose doxepin) does usually require PA if it’s covered at all.

Will my Medicare Part D plan cover trazodone for sleep even though it’s prescribed off-label?

Yes. Medicare Part D covers medications for any medically accepted indication, which includes common off-label uses. Trazodone for insomnia is widely recognized and accepted in medical practice, so Part D plans cover it without issue when prescribed appropriately by a licensed provider.

Can I get trazodone or doxepin through telehealth?

Absolutely. Trazodone and doxepin are non-controlled medications, so they can be prescribed via telehealth without the restrictions that apply to controlled substances like Ambien or Ativan. Providers like Klarity Health routinely prescribe these medications after appropriate evaluation, and you can fill them at your local pharmacy just as you would an in-person prescription.

What if my insurance covers the medication but I can’t afford the copay?

If you have insurance but your copay is still challenging, explore these options: (1) Use a pharmacy discount coupon like GoodRx—sometimes the discount price is actually lower than your insurance copay; (2) Ask your pharmacist if they have any discount programs; (3) Contact the medication manufacturer to ask about copay assistance (though for these inexpensive generics, this is less common); (4) Discuss with your doctor whether there’s an even more affordable alternative.

Do I need to try other sleep medications before insurance will cover trazodone or doxepin?

Generally no. Unlike controlled sleep medications where step therapy is common, trazodone and generic doxepin typically don’t require you to ‘fail’ other medications first. Insurance views these as appropriate first-line options for insomnia.

How do I know if my specific insurance plan covers these medications?

Check your plan’s formulary (drug list), usually available on your insurance company’s website or member portal. You can also call the customer service number on your insurance card and ask specifically about trazodone or doxepin coverage. Your pharmacy can also run a test claim before filling the prescription to show you exactly what your copay will be.

What’s the difference between the brand name Silenor and generic doxepin for insurance coverage?

Huge difference. Generic doxepin is widely covered as a Tier 1 medication with minimal copays and no prior authorization. Brand-name Silenor faces much tighter restrictions: many plans don’t cover it at all, those that do usually place it in Tier 3 or 4 with high copays, and prior authorization requiring trial of generic doxepin first is standard.

Take the Next Step Toward Better Sleep

If insomnia is affecting your daily life, you don’t have to navigate the insurance maze alone. Understanding coverage for medications like trazodone and doxepin is the first step—but getting actual treatment is what makes the difference.

Ready to explore your options? Klarity Health offers convenient telehealth appointments with experienced providers who can evaluate your sleep concerns and discuss appropriate treatment options. With appointments available seven days a week and transparent pricing for both insured and cash-pay patients, getting help for insomnia has never been more accessible.

The combination of broad insurance coverage, affordable self-pay prices, and no controlled substance restrictions makes trazodone and doxepin excellent options for many people struggling with sleep. Whether you’re dealing with occasional insomnia or chronic sleep problems, a proper evaluation can determine if these medications are right for you—and get you on the path to better rest.

Schedule your appointment today and take control of your sleep health. Better nights are within reach.

Research and Citations

Research Currency Statement
Verified as of: December 16, 2025

Top 5 Citations

1. Ambetter (Centene) 2025 Formulary – Commercial insurance formulary showing tier placement and coverage status for trazodone and doxepin. Updated January 1, 2025. Available at: www.scribd.com/document/808015757/2025-al-formulary

2. California Medi-Cal Rx Contract Drugs List – Official state Medicaid formulary documenting coverage of trazodone without prior authorization. Effective April 1, 2023 (active through 2025). Available at: www.scribd.com/document/759244502/Medi-Cal-Rx-Contract-Drugs-List-FINAL

3. Texas Health and Human Services Commission Preferred Drug List Updates – State Medicaid PDL update confirming preferred status for trazodone. Published January 2025. Available at: www.superiorhealthplan.com/newsroom/eff-1302025-texas-medicaid-preferred-drug-list-updates-01062025.html

4. Florida Medicaid Preferred Drug List (AHCA) – Agency for Health Care Administration PDL showing generic coverage for insomnia medications. Updated October 1, 2025. Available at: ahca.myflorida.com/medicaid/prescribed-drugs/medicaid-pharmaceutical-therapeutics-committee/florida-medicaid-preferred-drug-list-pdl

5. Pennsylvania Statewide Medicaid Preferred Drug List – Official PDL documenting preferred status for generic trazodone. Effective July 7, 2025. Available at: www.papdl.com/preferred-drug-list

Formularies checked include: Ambetter (Centene) 2025 formulary (updated January 1, 2025); UnitedHealthcare prior authorization criteria (updated through November 2025); Aetna clinical policies (through 2024); Cigna and Humana 2025 drug list information; Kaiser 2025 formulary data.

GoodRx prices verified as of December 2025. Medicaid formularies verified for California, Texas, Florida, New York, Pennsylvania, and Illinois through their respective state health departments and published preferred drug lists (latest available 2024-2025 data).

Source:

• https://www.scribd.com/document/808015757/2025-al-formulary#:~:text=Ambetter%20Formulary%20Updated%20January%201%2C,2025
• https://www.scribd.com/document/759244502/Medi-Cal-Rx-Contract-Drugs-List-FINAL#:~:text=DHCS%20%E2%80%93%20,List%20132%2004%2F01%2F2023
• https://www.superiorhealthplan.com/newsroom/eff-1302025-texas-medicaid-preferred-drug-list-updates-01062025.html#:~:text=The%20Texas%20Health%20and%20Human,Drug%20Formulary%20and%20the%20PDL
• https://ahca.myflorida.com/medicaid/prescribed-drugs/medicaid-pharmaceutical-therapeutics-committee/florida-medicaid-preferred-drug-list-pdl#:~:text=The%20Changes%20Summary%20Report%20lists,current%20list%20of%20preferred%20drugs
• https://www.goodrx.com/trazodone/what-is?srsltid=AfmBOoqg9EoI3nICH9r8cmQZcpvHhfmxwkipR5QwsxQfPHAo0ClwGT#:~:text=Allison%20Gourley%2C%20PharmD
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• https://www.scribd.com/document/808015757/2025-al-formulary#:~:text=trazodone%20hcl%20TABS%201B%20imipramine,PA%20imipramine%20pamoate%201B
• https://www.scribd.com/document/808015757/2025-al-formulary#:~:text=doxepin%20hcl%20CAPS%201B%20nefazodone,1B%20trazodone%20hcl%20TABS%201B
• https://www.westernhealth.com/provider/prior-authorization-criteria/?category=Premium&glId=GL-264208#:~:text=,Zolpidem%20capsules%2C%20Edluar