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Does Medicare Part D cover Erzofri?

Erzofri appears on the Medicare Part D formularies of 117 payers in the corpus, across 1,836 plans. 19 payers require prior authorization on every covering plan, 0 on some plans, and 98 on none.

Beyond prior authorization: 22 covering plans require step therapy (another drug tried first) and 1,596 apply a quantity limit, on at least one Erzofri product.

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 authStep therapyQuantity limitStatus
Aetna (CVS Health)65300653No prior authorization
Devoted Health41500415No prior authorization
Kaiser Permanente115000No prior authorization
SCAN Health Plan74000No prior authorization
Molina Healthcare510051No prior authorization
Zing Health Of Michigan, INC.330033No prior authorization
Triple S Advantage, INC.220220No prior authorization
Mcs Advantage, INC.2020020Prior authorization required
California Physicians' Service1717017Prior authorization required
Blue Cross Blue Shield (affiliate)160016No prior authorization
Excellus Health Plan, INC.16000No prior authorization
Central Health Plan Of California, INC.150015No prior authorization
Selecthealth, INC.1414014Prior authorization required
Clover Health130013No prior authorization
Prominence Healthfirst Of Texas130013No prior authorization
Atrio Health Plans120012No prior authorization
Mount Carmel Health Plan, INC.110011No prior authorization
Allina Health And Aetna Insurance Company9009No prior authorization
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9009No prior authorization
Mvp Health Plan, INC.8008No prior authorization
Network Health Insurance Corporation8000No prior authorization
Prominence Healthfirst8008No prior authorization
Viva Health, INC.7007No prior authorization
Martin'S Point Generations Advantage, INC.7007No prior authorization
Astiva Health, INC.7007No prior authorization
Summacare INC.7007No prior authorization
Champion Health Plan Of California INC7007No prior authorization
Champion Health Plan Of Nevada, INC.7007No prior authorization
Providence Health Assurance7007No prior authorization
Alterwood Advantage, INC.7007No prior authorization
Mass General Brigham Health Plan, INC6006No prior authorization
Christus Health Plan6006No prior authorization
Gold Kidney Of Florida INC6006No prior authorization
Presbyterian Health Plan6606Prior authorization required
Elderplan, INC.6006No prior authorization
Connecticare, INC.6006No prior authorization
Globalhealth, INC.6006No prior authorization
Chinese Community Health Plan5005No prior authorization
Hopkins Health Advantage, INC.5005No prior authorization
Oh Chs Snp INC.5005No prior authorization
Usable Mutual Insurance Company5005No prior authorization
Gold Kidney Of Arizona5005No prior authorization
Prominence Healthfirst Of Florida INC5005No prior authorization
Hpmp Of Florida, INC.5005No prior authorization
Hawaii Medical Service Association4004No prior authorization
Leon Health, INC.4004No prior authorization
Verda Health Plan Of Texas INC4004No prior authorization
Sharp Health Plan4004No prior authorization
Clever Care Of Golden State, INC.4004No prior authorization
Aspire Health Plan4004No prior authorization
Metroplus Health Plan, INC.3003No prior authorization
Mount Carmel Health Insurance Company3003No prior authorization
Village Senior Services Corporation3003No prior authorization
Senior Whole Health, LLC3003No prior authorization
Baycare Select Health Plans, INC.3003No prior authorization
Cox Health Systems HMO INC3003No prior authorization
Capital District Physicians' Health Plan, INC.3000No prior authorization
Paramount Care, INC.3003No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3003No prior authorization
Geisinger Indemnity Insurance Company3303Prior authorization required
Vns Choice3003No prior authorization
Mercy Care3003No prior authorization
Usable HMO, INC.3003No prior authorization
Mclaren Health Plan, INC.3003No prior authorization
Southeastern Indiana Health Organization, INC.3003No prior authorization
Amerihealth Caritas Vip Next, INC.2202Prior authorization required
Commonwealth Care Alliance, INC.2002No prior authorization
Arkansas Superior Select, INC.2002No prior authorization
Neighborhood Health Plan Of Rhode Island2002No prior authorization
Signature Advantage, LLC2002No prior authorization
Primewest Rural Mn Health Care Access Initiative2002No prior authorization
South Country Health Alliance2202Prior authorization required
Verda Health Plan Of Arizona, INC.2002No prior authorization
Vista Health Plan, INC.2202Prior authorization required
New Century Health Plan, INC.2002No prior authorization
Troy Health, INC.2202Prior authorization required
Community Health Group2002No prior authorization
Texas Independence Health Plan, INC.2002No prior authorization
Imperial Health Plan Of California, INC.2002No prior authorization
Denver Health Medical Plan, INC.2002No prior authorization
Senior Whole Health Of New York, INC.2002No prior authorization
Elite Health Plan, INC.2002No prior authorization
Excellus Health Plan Community Care LLC2000No prior authorization
Visiting Nurse Association Of Central New York2002No prior authorization
Trinity Health Plan Of Michigan INC2002No prior authorization
Mount Carmel Health Plan Of New York, INC.2002No prior authorization
Elevance Health (Anthem)2002No prior authorization
Tsg Guard, INC.1001No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.1001No prior authorization
Imperial County Local Health Authority1001No prior authorization
Alameda Alliance For Health1101Prior authorization required
Itasca Medical Care1001No prior authorization
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Connecticare Insurance Company, INC.1001No prior authorization
Allcare Health Plan, INC.1001No prior authorization
Santa Clara County Health Authority1001No prior authorization
Kern Health Systems1001No prior authorization
Select Health Of South Carolina, INC.1101Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1101Prior authorization required
Paramount Insurance Company1001No prior authorization
Orange County Health Authority1001No prior authorization
Health Choice Arizona, INC.1001No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1001No prior authorization
San Joaquin County Health Commission1001No prior authorization
Aids Healthcare Foundation1001No prior authorization
San Mateo Health Commission1101Prior authorization required
Amerihealth Michigan, INC.1101Prior authorization required
Amerihealth Caritas Florida, INC.1101Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1001No prior authorization
Amerihealth Caritas North Carolina, INC.1101Prior authorization required
Hawaii Medical Service Association (Hmsa)1001No prior authorization
Healthy Mississippi, INC.1101Prior authorization required
Inland Empire Health Plan1001No prior authorization
West Virginia Senior Advantage, INC.1001No prior authorization
Healthfirst Insurance Company, INC.1001No prior authorization

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Erzofri product on its formulary carries that condition.

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.