Medicare plans typically list zolpidem in Tier 2 of their formulary. Tier 2 means that this drug is a “non-preferred generic”. It will be expensive and there may be. Please enter a medication name below (minimum four letters) and click the "search" button. Search alphabetically by medication name. Select the letter to move. May 1, - OHP Drug List. (Formulary). For members of Columbia Pacific, Health Share/CareOregon and Jackson Care Connect. Out of Pocket Costs. Does ambien plan have generic Medicare Set Aside Arrangements. A server error occured, please refresh the page and try again We apologize for the inconvenience. Click on a tab formulary Deductible. Entering the Donut Hole. Choosing a Medicare Plan.