Benefily

Does Medicare Part D cover Astagraf?

Astagraf appears on the Medicare Part D formularies of 161 payers in the corpus. 161 require prior authorization on every covering plan, 0 on some plans, and 0 on none.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

PayerPlans coveringRequire prior authStatus
UnitedHealthcare731731Prior authorization required
Aetna (CVS Health)643643Prior authorization required
Devoted Health415415Prior authorization required
SCAN Health Plan7474Prior authorization required
Blue Cross Blue Shield (affiliate)7070Prior authorization required
Molina Healthcare5151Prior authorization required
Simply Healthcare Plans, INC.5050Prior authorization required
Uhc Of California4040Prior authorization required
Priority Health3737Prior authorization required
Preferred Care Partners, INC.3535Prior authorization required
Zing Health Of Michigan, INC.3333Prior authorization required
Triple S Advantage, INC.2222Prior authorization required
Physicians Health Choice Of Texas, LLC2222Prior authorization required
Mmm Healthcare, LLC2020Prior authorization required
Upmc Health Plan, INC.1717Prior authorization required
Bluecross Blueshield Of Tennessee, INC.1717Prior authorization required
Excellus Health Plan, INC.1616Prior authorization required
Central Health Plan Of California, INC.1515Prior authorization required
Blue Care Network Of Michigan1515Prior authorization required
Selecthealth, INC.1414Prior authorization required
Peoples Health, INC.1313Prior authorization required
Clover Health1313Prior authorization required
Healthsun Health Plans, INC.1313Prior authorization required
Prominence Healthfirst Of Texas1313Prior authorization required
Atrio Health Plans1212Prior authorization required
Upmc Health Network, INC.1212Prior authorization required
Mount Carmel Health Plan, INC.1111Prior authorization required
Pacificsource Community Health Plans1111Prior authorization required
Quartz Health Plan Corporation1010Prior authorization required
Sanford Health Plan99Prior authorization required
Allina Health And Aetna Insurance Company99Prior authorization required
Geisinger Health Plan99Prior authorization required
Doctors Healthcare Plans, INC.99Prior authorization required
Mvp Health Plan, INC.88Prior authorization required
Network Health Insurance Corporation88Prior authorization required
Prominence Healthfirst88Prior authorization required
Fallon Community Health Plan88Prior authorization required
Viva Health, INC.77Prior authorization required
Martin'S Point Generations Advantage, INC.77Prior authorization required
Astiva Health, INC.77Prior authorization required
Summacare INC.77Prior authorization required
Champion Health Plan Of California INC77Prior authorization required
Champion Health Plan Of Nevada, INC.77Prior authorization required
Alterwood Advantage, INC.77Prior authorization required
Mass General Brigham Health Plan, INC66Prior authorization required
Christus Health Plan66Prior authorization required
Wellpoint Health Plans, INC.66Prior authorization required
Gold Kidney Of Florida INC66Prior authorization required
Hometown Health Plan, INC.66Prior authorization required
Presbyterian Health Plan66Prior authorization required
Elderplan, INC.66Prior authorization required
Connecticare, INC.66Prior authorization required
Globalhealth, INC.66Prior authorization required
Preferred Care Network, INC.66Prior authorization required
Chinese Community Health Plan55Prior authorization required
Hopkins Health Advantage, INC.55Prior authorization required
Wellpoint Texas, INC.55Prior authorization required
Oh Chs Snp INC.55Prior authorization required
Usable Mutual Insurance Company55Prior authorization required
HMO Colorado, INC.55Prior authorization required
Gold Kidney Of Arizona55Prior authorization required
Prominence Healthfirst Of Florida INC55Prior authorization required
Priority Health Choice, INC.55Prior authorization required
Hpmp Of Florida, INC.55Prior authorization required
Care N' Care Insurance Company Of North Carolina44Prior authorization required
Health New England, INC.44Prior authorization required
Hawaii Medical Service Association44Prior authorization required
Leon Health, INC.44Prior authorization required
Verda Health Plan Of Texas INC44Prior authorization required
Security Health Plan Of Wisconsin, INC.44Prior authorization required
Sharp Health Plan44Prior authorization required
Clever Care Of Golden State, INC.44Prior authorization required
Aspire Health Plan44Prior authorization required
Quartz Health Plan Mn Corporation44Prior authorization required
Medisun, INC.33Prior authorization required
Metroplus Health Plan, INC.33Prior authorization required
Eternalhealth, INC.33Prior authorization required
Mount Carmel Health Insurance Company33Prior authorization required
Village Senior Services Corporation33Prior authorization required
Senior Whole Health, LLC33Prior authorization required
Baycare Select Health Plans, INC.33Prior authorization required
Cox Health Systems HMO INC33Prior authorization required
Volunteer State Health Plan33Prior authorization required
Independent Health Association, INC.33Prior authorization required
Capital District Physicians' Health Plan, INC.33Prior authorization required
Elevance Health (Anthem)33Prior authorization required
Eternalhealth Of Arizona INC33Prior authorization required
Paramount Care, INC.33Prior authorization required
Aultcare Health Insuring Corporation33Prior authorization required
Mount Carmel Health Plan Of Idaho, INC.33Prior authorization required
Geisinger Indemnity Insurance Company33Prior authorization required
Vns Choice33Prior authorization required
Mercy Care33Prior authorization required
Usable HMO, INC.33Prior authorization required
Mclaren Health Plan, INC.33Prior authorization required
Southeastern Indiana Health Organization, INC.33Prior authorization required
Bluecross And Blueshield Of South Carolina33Prior authorization required
Wellpoint Insurance Company33Prior authorization required
Hamaspik, INC.22Prior authorization required
Arizona Physicians Ipa, INC.22Prior authorization required
Amerihealth Caritas Vip Next, INC.22Prior authorization required
Beshp, INC.22Prior authorization required
Florida Blue Medicare, INC.22Prior authorization required
Commonwealth Care Alliance, INC.22Prior authorization required
Arkansas Superior Select, INC.22Prior authorization required
Neighborhood Health Plan Of Rhode Island22Prior authorization required
Signature Advantage, LLC22Prior authorization required
Primewest Rural Mn Health Care Access Initiative22Prior authorization required
South Country Health Alliance22Prior authorization required
Verda Health Plan Of Arizona, INC.22Prior authorization required
Sanford Health Plan Of Minnesota22Prior authorization required
Vista Health Plan, INC.22Prior authorization required
Upmc For You, INC22Prior authorization required
New Century Health Plan, INC.22Prior authorization required
Troy Health, INC.22Prior authorization required
Community Health Group22Prior authorization required
Texas Independence Health Plan, INC.22Prior authorization required
Imperial Health Plan Of California, INC.22Prior authorization required
Denver Health Medical Plan, INC.22Prior authorization required
Senior Whole Health Of New York, INC.22Prior authorization required
Nextblue Of North Dakota Insurance Company22Prior authorization required
Elite Health Plan, INC.22Prior authorization required
Good Samaritan Insurance Plan Of Nebraska, INC.22Prior authorization required
Excellus Health Plan Community Care LLC22Prior authorization required
Visiting Nurse Association Of Central New York22Prior authorization required
Trinity Health Plan Of Michigan INC22Prior authorization required
Wyoblue Advantage INC22Prior authorization required
Mount Carmel Health Plan Of New York, INC.22Prior authorization required
Hm Health Insurance Company22Prior authorization required
Tsg Guard, INC.11Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.11Prior authorization required
Imperial County Local Health Authority11Prior authorization required
Community Care Health Plan, INC.11Prior authorization required
Alameda Alliance For Health11Prior authorization required
Itasca Medical Care11Prior authorization required
Amerihealth Caritas Louisiana, INC.11Prior authorization required
Connecticare Insurance Company, INC.11Prior authorization required
Allcare Health Plan, INC.11Prior authorization required
Samaritan Health Plans, INC.11Prior authorization required
Santa Clara County Health Authority11Prior authorization required
Kern Health Systems11Prior authorization required
Select Health Of South Carolina, INC.11Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health11Prior authorization required
Paramount Insurance Company11Prior authorization required
Orange County Health Authority11Prior authorization required
Health Choice Arizona, INC.11Prior authorization required
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic11Prior authorization required
San Joaquin County Health Commission11Prior authorization required
Aids Healthcare Foundation11Prior authorization required
Health Plan Of Careoregon, INC.11Prior authorization required
Amerihealth Michigan, INC.11Prior authorization required
Amerihealth Caritas Florida, INC.11Prior authorization required
Upmc Health Coverage, INC.11Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba11Prior authorization required
San Francisco Health Authority Dba San Francisco Health Plan11Prior authorization required
Amerihealth Caritas North Carolina, INC.11Prior authorization required
Hawaii Medical Service Association (Hmsa)11Prior authorization required
Healthy Mississippi, INC.11Prior authorization required
Inland Empire Health Plan11Prior authorization required
West Virginia Senior Advantage, INC.11Prior authorization required
Healthfirst Insurance Company, INC.11Prior authorization required

“Require prior auth” counts a plan when any Astagraf product on its formulary needs authorization.

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.