{"id":630446,"date":"2024-11-14T10:25:55","date_gmt":"2024-11-14T15:25:55","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630446"},"modified":"2026-01-13T16:14:03","modified_gmt":"2026-01-13T21:14:03","slug":"does-medicaid-cover-quviviq","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicaid-cover-quviviq\/","title":{"rendered":"Does Medicaid cover Quviviq?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Getting a good night\u2019s sleep is essential for your overall health and well-being. Unfortunately, getting restful sleep can be challenging for those dealing with chronic <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/insomnia-treatment-and-medications\"><span style=\"font-weight: 400;\">insomnia<\/span><\/a><span style=\"font-weight: 400;\">, however. <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/quviviq\"><span style=\"font-weight: 400;\">Quviviq<\/span><\/a><span style=\"font-weight: 400;\"> is a brand-name medication used once a day to treat insomnia. In a class of drugs called dual orexin receptor antagonists (DORAs), Quviviq works by regulating the sleep-wake cycle, helping people fall asleep faster and stay asleep longer. Although Medicaid may cover Quiviviq, there are certain details you should be aware of if you\u2019re trying to determine how much you will be expected to pay for it.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"does-medicaid-cover-quviviq\"><span style=\"font-weight: 400;\">Does Medicaid cover Quviviq?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicaid may cover Quviviq, but the coverage varies by state. Medicaid is a state-run program, so each state has a list of approved medicines called a preferred drug list or a formulary. It states not only whether a medication is a preferred or nonpreferred drug, but also what tier it is on and whether there are additional requirements that need to be met for coverage. In some states, Medicaid might fully cover the cost of Quviviq if it&#8217;s deemed medically necessary.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Since <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/quviviq\/what-is\"><span style=\"font-weight: 400;\">Quviviq<\/span><\/a><span style=\"font-weight: 400;\"> is labeled as a controlled substance, Medicaid may not cover it in the same way it would cover other drugs with less potential for misuse.\u00a0<\/span><\/p>\n<h3 id=\"factors-influencing-medicaid-coverage-for-quviviq\"><span style=\"font-weight: 400;\">Factors influencing Medicaid coverage for Quviviq<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If your state\u2019s Medicaid program covers Quviviq, you may need to contend with several restrictions. These can include:<\/span><\/p>\n<ul>\n<li><b>Prior authorization:<\/b><span style=\"font-weight: 400;\"> In some cases, Medicaid might require a special healthcare provider\u2019s request, called <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\"><span style=\"font-weight: 400;\">prior authorization<\/span><\/a><span style=\"font-weight: 400;\">, before it covers Quviviq. This means your healthcare provider must submit a formal request to Medicaid explaining why Quviviq is necessary for your treatment.\u00a0\u00a0<\/span><\/li>\n<li><b>Step therapy:<\/b><span style=\"font-weight: 400;\"> Some states may require you to try other similar medications before approving Quviviq. This process, called <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/step-therapy\/\"><span style=\"font-weight: 400;\">step therapy<\/span><\/a><span style=\"font-weight: 400;\">, involves trying less expensive or more established treatments before moving to Quviviq.<\/span><\/li>\n<li><b>Quantity limits: <\/b><span style=\"font-weight: 400;\">Medicaid may cover only a specific amount of medication per month.\u00a0<\/span><\/li>\n<\/ul>\n<p>For example, the <a href=\"https:\/\/newyork.fhsc.com\/downloads\/providers\/nyrx_pdp_pdl.pdf\">Medicaid Pharmacy Program Preferred Drug List for New York<\/a> lists Quviviq as a nonpreferred drug, meaning it will cost more than preferred drugs. It also has a 90-day coverage limit.\u00a0<b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">Since coverage varies so widely, it\u2019s best to contact your local Medicaid office to determine your amount of coverage and any other requirements that need to be met. Your healthcare provider or pharmacist can help with coverage questions as well.<\/span><\/p>\n<h2 id=\"how-much-does-quviviq-cost\"><span style=\"font-weight: 400;\">How much does Quviviq cost?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The average retail <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/quviviq-without-insurance\/\"><span style=\"font-weight: 400;\">cost of Quviviq without insurance<\/span><\/a><span style=\"font-weight: 400;\"> is about $676 for 30, 50 mg tablets. Prices fluctuate, however, and they can vary significantly by pharmacy.\u00a0<\/span><\/p>\n<h3 id=\"how-to-get-quviviq-with-medicaid\"><span style=\"font-weight: 400;\">How to get Quviviq with Medicaid<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The process of getting a sleep aid like Quviviq with Medicaid may not be the same as it would be for other medications. Here\u2019s what you may expect:\u00a0<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Consult your healthcare provider.<\/b><span style=\"font-weight: 400;\"> They may want you to try other medications with less potential for dependence first. Or they may recommend <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-sleep-better\/\"><span style=\"font-weight: 400;\">lifestyle adjustments<\/span><\/a><span style=\"font-weight: 400;\">, like cutting out certain foods from your diet or going to bed sooner. If those methods fail, they may write you a prescription.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Check your Medicaid coverage.<\/b><span style=\"font-weight: 400;\"> Verify whether your state\u2019s Medicaid program covers Quviviq. You can do this by visiting your state\u2019s Medicaid website, contacting your local Medicaid office, or asking your pharmacist. If it doesn\u2019t cover Quviviq, or if the copay is too high, you may want to talk to your healthcare provider about Quviviq alternatives, such as <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/quviviq-vs-ambien\/\"><span style=\"font-weight: 400;\">Ambien<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/quviviq-vs-belsomra\/\"><span style=\"font-weight: 400;\">Belsomra<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Wait for prior authorization.<\/b><span style=\"font-weight: 400;\"> If your state Medicaid program requires prior authorization for Quviviq, you may have to wait longer than you\u2019d have to wait for other medications. If required, your healthcare provider will submit a prior authorization request to Medicaid. This request must demonstrate that Quviviq is medically necessary for you.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Fill your prescription. <\/b><span style=\"font-weight: 400;\">Once you\u2019ve received approval from Medicaid, you can let your healthcare provider know which pharmacy you want them to send your prescription to.\u00a0\u00a0<\/span><\/li>\n<\/ol>\n<h2 id=\"costs-of-quviviq-with-medicaid\"><span style=\"font-weight: 400;\">Costs of Quviviq with Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicaid generally helps reduce the cost of medications, but you may still have some of your expenses. These can include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Copays:<\/strong> Some states require a small fee for prescription medications. Depending on your state&#8217;s rules, this copayment can range from less than $1 to $15, sometimes more.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Coinsurance:<\/strong> In some cases, you might need to pay a percentage of the medication\u2019s cost, known as coinsurance. The amount is based on your state\u2019s Medicaid guidelines.<\/span><\/li>\n<\/ul>\n<h2 id=\"ways-to-get-discounts-on-quviviq-without-medicaid\"><span style=\"font-weight: 400;\">Ways to get discounts on Quviviq without Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you don\u2019t have Medicaid or if your state doesn\u2019t cover Quviviq, there are other ways to save on the medication, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>The SingleCare prescription discount card:<\/b><span style=\"font-weight: 400;\"> SingleCare can help you save on Quviviq at participating pharmacies across the country. With a SingleCare coupon, you can pay $438 instead of $676 for a one-month supply of Quviviq. You can use SingleCare coupons if you\u2019re a Medicaid beneficiary, but you can\u2019t combine SingleCare savings with Medicaid.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Generic alternatives:<\/b><span style=\"font-weight: 400;\"> While Quviviq doesn&#8217;t have a generic version yet, your healthcare provider might know of other similar medications that have more affordable generic alternatives. It\u2019s worth asking your local pharmacy if they have any available discounts.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Medicare and Medicare Extra Help: <\/b><span style=\"font-weight: 400;\">If you have both Medicare and Medicaid, you are considered dually eligible, meaning <\/span><a href=\"https:\/\/www.medicare.gov\/basics\/costs\/help\/medicaid\"><span style=\"font-weight: 400;\">you can use Medicaid to pay for certain things that Medicare won\u2019t<\/span><\/a><span style=\"font-weight: 400;\">. This may or may not apply to prescriptions. You may qualify for the Part D Low Income Subsidy (LIS) program, also known as <\/span><a href=\"https:\/\/www.medicare.gov\/basics\/costs\/help\/drug-costs\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/a><span style=\"font-weight: 400;\">, if you find it difficult to afford Quviviq with Medicare.<\/span><\/li>\n<\/ul>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/quviviq-savings\/\"><b>How to save on Quviviq<\/b><\/a><\/p>\n<p><span style=\"font-weight: 400;\">By taking these steps, you can make Quviviq more affordable and access the treatment you need to improve your sleep and overall well-being.<\/span><\/p>\n<p><small><i><span style=\"font-weight: 400;\">The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jan. 13, 2026. Prices vary by pharmacy. Visit our <\/span><\/i><a href=\"https:\/\/www.singlecare.com\/prescription\/quviviq\"><i><span style=\"font-weight: 400;\">Quviviq coupon page<\/span><\/i><\/a><i><span style=\"font-weight: 400;\"> for updated Quviviq prices near you.<\/span><\/i><small><\/small><\/small><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Getting a good night\u2019s sleep is essential for your overall health and well-being. Unfortunately, getting restful sleep can be challenging for those dealing with chronic insomnia, however. Quviviq is a brand-name medication used once a day to treat insomnia. In a class of drugs called dual orexin receptor antagonists (DORAs), Quviviq works by regulating the [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":630447,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[15103,16,816],"coauthors":[21032],"class_list":["post-630446","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-drug-pricing","tag-medicaid","tag-sleep","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Medicaid cover Quviviq?<\/title>\n<meta name=\"description\" content=\"Medicaid may cover Quviviq, but your state\u2019s Medicaid program may place certain restrictions on it or place it on a higher tier.\" \/>\n<meta name=\"robots\" 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