Benefily

Does Medicare Part D cover Haegarda?

Haegarda appears on the Medicare Part D formularies of 255 payers in the corpus, across 4,956 plans. 254 payers require prior authorization on every covering plan, 0 on some plans, and 1 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 3,219 apply a quantity limit, on at least one Haegarda 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
Humana8178170817Prior authorization required
UnitedHealthcare73173100Prior authorization required
Aetna (CVS Health)6586580658Prior authorization required
Devoted Health4154150415Prior authorization required
Centene (WellCare)1971970197Prior authorization required
Blue Cross Blue Shield (affiliate)183183090Prior authorization required
Cigna17117100Prior authorization required
Kaiser Permanente115000No prior authorization
Elevance Health (Anthem)676702Prior authorization required
Alignment Healthcare6767067Prior authorization required
Molina Healthcare5151051Prior authorization required
Cariten Health Plan INC.4444044Prior authorization required
Uhc Of California404000Prior authorization required
Priority Health373700Prior authorization required
Careplus Health Plans, INC.3636036Prior authorization required
Bravo Health Pennsylvania, INC.353500Prior authorization required
Preferred Care Partners, INC.353500Prior authorization required
Zing Health Of Michigan, INC.3333033Prior authorization required
Health Care Service Corporation3131031Prior authorization required
Medco Containment Life And Medco Containment Ny272700Prior authorization required
Solis Health Plans, INC.2424024Prior authorization required
Sunshine State Health Plan, INC.2424024Prior authorization required
Freedom Health, INC.242400Prior authorization required
Capital Advantage Insurance Company2323023Prior authorization required
Physicians Health Choice Of Texas, LLC222200Prior authorization required
Tufts Associated Health Maintenance Organization212100Prior authorization required
Harmony Health Plan, INC.1919019Prior authorization required
Hcsc Insurance Services Company1818018Prior authorization required
California Physicians' Service171700Prior authorization required
Upmc Health Plan, INC.171700Prior authorization required
Bluecross Blueshield Of Tennessee, INC.1717017Prior authorization required
Wellpoint Texas, INC.161600Prior authorization required
Excellus Health Plan, INC.1616016Prior authorization required
Superior Healthplan, INC.1515015Prior authorization required
Optimum Healthcare, INC.151500Prior authorization required
Central Health Plan Of California, INC.1515015Prior authorization required
Blue Care Network Of Michigan151500Prior authorization required
Selecthealth, INC.1414014Prior authorization required
Wellpoint Insurance Company141400Prior authorization required
Florida Blue Medicare, INC.1313013Prior authorization required
Peoples Health, INC.131300Prior authorization required
Clover Health1313013Prior authorization required
Prominence Healthfirst Of Texas1313013Prior authorization required
Atrio Health Plans1212012Prior authorization required
Upmc Health Network, INC.121200Prior authorization required
Mount Carmel Health Plan, INC.1111011Prior authorization required
Pacificsource Community Health Plans111100Prior authorization required
Community Insurance Company101000Prior authorization required
Health Insurance Plan Of Greater New York1010010Prior authorization required
HMO Colorado, INC.101000Prior authorization required
Compcare Health Services Insurance Corporation101000Prior authorization required
Allina Health And Aetna Insurance Company9909Prior authorization required
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9909Prior authorization required
New York Quality Healthcare Corporation9909Prior authorization required
Wellpoint Tennessee, INC.9900Prior authorization required
Healthier New Jersey Insurance Company8808Prior authorization required
Meridian Health Plan Of Michigan, INC.8808Prior authorization required
Healthpartners, INC.8800Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8808Prior authorization required
Mvp Health Plan, INC.8808Prior authorization required
Keystone Health Plan East, INC.8800Prior authorization required
Network Health Insurance Corporation8800Prior authorization required
Prominence Healthfirst8808Prior authorization required
Fallon Community Health Plan8800Prior authorization required
Peak Health Insurance Corporation8808Prior authorization required
Health Partners Plans, INC.8800Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8808Prior authorization required
Viva Health, INC.7707Prior authorization required
Martin'S Point Generations Advantage, INC.7707Prior authorization required
Wellpoint Health Plans, INC.7700Prior authorization required
Astiva Health, INC.7707Prior authorization required
Bravo Health Mid-Atlantic, INC.7700Prior authorization required
Health Alliance Plan Of Michigan7700Prior authorization required
Summacare INC.7707Prior authorization required
Keystone Health Plan Central, INC.7707Prior authorization required
Champion Health Plan Of California INC7707Prior authorization required
Champion Health Plan Of Nevada, INC.7707Prior authorization required
Providence Health Assurance7700Prior authorization required
Alterwood Advantage, INC.7707Prior authorization required
Buckeye Community Health Plan, INC.6606Prior authorization required
Christus Health Plan6606Prior authorization required
Nebraska Total Care, INC.6606Prior authorization required
Gold Kidney Of Florida INC6606Prior authorization required
Elderplan, INC.6606Prior authorization required
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6606Prior authorization required
Globalhealth, INC.6606Prior authorization required
Preferred Care Network, INC.6600Prior authorization required
Scott And White Health Plan6606Prior authorization required
Coordinated Care Of Washington, INC.5505Prior authorization required
Chinese Community Health Plan5505Prior authorization required
Hopkins Health Advantage, INC.5505Prior authorization required
Alliance Health And Life Insurance Company5500Prior authorization required
Sapphire Edge, INC.5505Prior authorization required
Independent Health Association, INC.5500Prior authorization required
Coordinated Care Corporation5505Prior authorization required
Oh Chs Snp INC.5505Prior authorization required
Usable Mutual Insurance Company5505Prior authorization required
Gold Kidney Of Arizona5505Prior authorization required
Meridian Health Plan Of Illinois, INC.5505Prior authorization required
Sunflower State Health Plan, INC.5505Prior authorization required
Prominence Healthfirst Of Florida INC5505Prior authorization required
Priority Health Choice, INC.5500Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5505Prior authorization required
Hpmp Of Florida, INC.5505Prior authorization required
Home State Health Plan, INC.4404Prior authorization required
Baylor Scott & White Insurance Company4404Prior authorization required
Pennsylvania Health & Wellness, INC.4404Prior authorization required
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4404Prior authorization required
Qcc Insurance Company4400Prior authorization required
Leon Health, INC.4404Prior authorization required
Verda Health Plan Of Texas INC4404Prior authorization required
Sharp Health Plan4404Prior authorization required
Gateway Health Plan, INC.4400Prior authorization required
Capital Health Plan4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4404Prior authorization required
Clever Care Of Golden State, INC.4404Prior authorization required
Central Mass Health, LLC4404Prior authorization required
Ghs Insurance Company4404Prior authorization required
Amh Health, LLC4400Prior authorization required
Dean Health Plan, INC.4404Prior authorization required
Metroplus Health Plan, INC.3303Prior authorization required
Wellpoint West Virginia , INC.3300Prior authorization required
Patrius Health, INC.3303Prior authorization required
Marquis Advantage, INC.3303Prior authorization required
Partners Insurance Company INC3300Prior authorization required
Mount Carmel Health Insurance Company3303Prior authorization required
Community Care Health Plan Of Louisiana, INC.3300Prior authorization required
Village Senior Services Corporation3303Prior authorization required
Trillium Community Health Plan, INC.3303Prior authorization required
Senior Whole Health, LLC3303Prior authorization required
Baycare Select Health Plans, INC.3303Prior authorization required
Cox Health Systems HMO INC3303Prior authorization required
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3300Prior authorization required
Volunteer State Health Plan3303Prior authorization required
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3303Prior authorization required
Procare Advantage, LLC3303Prior authorization required
Paramount Care, INC.3303Prior authorization required
Mount Carmel Health Plan Of Idaho, INC.3303Prior authorization required
Geisinger Indemnity Insurance Company3303Prior authorization required
Simpra Advantage, INC.3303Prior authorization required
Celtic Insurance Company3303Prior authorization required
Amerihealth Insurance Company Of New Jersey3300Prior authorization required
Vns Choice3303Prior authorization required
Mercy Care3303Prior authorization required
Usable HMO, INC.3303Prior authorization required
Mclaren Health Plan, INC.3303Prior authorization required
Liberty Advantage, LLC3303Prior authorization required
Southeastern Indiana Health Organization, INC.3303Prior authorization required
Managed Health Services Insurance CORP.3303Prior authorization required
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Hamaspik, INC.2202Prior authorization required
Arizona Physicians Ipa, INC.2200Prior authorization required
Carepartners Of Connecticut, INC.2200Prior authorization required
Amerihealth Caritas Vip Next, INC.2202Prior authorization required
Wellpoint Iowa, INC.2200Prior authorization required
Commonwealth Care Alliance, INC.2202Prior authorization required
Arkansas Superior Select, INC.2202Prior authorization required
Wellpoint Washington, INC.2200Prior authorization required
Neighborhood Health Plan Of Rhode Island2202Prior authorization required
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2202Prior authorization required
Signature Advantage, LLC2202Prior authorization required
Primewest Rural Mn Health Care Access Initiative2202Prior authorization required
South Country Health Alliance2200Prior authorization required
Sentara Health Plans2202Prior authorization required
Verda Health Plan Of Arizona, INC.2202Prior authorization required
Partners Insurance Company Of New Jersey INC2200Prior authorization required
Nhc Advantage, LLC2202Prior authorization required
Vista Health Plan, INC.2202Prior authorization required
American Health Plan Of Ut, INC.2202Prior authorization required
Upmc For You, INC2200Prior authorization required
American Health Plan Of Missouri, INC.2202Prior authorization required
Selectcare Of Texas, INC.2202Prior authorization required
New Century Health Plan, INC.2202Prior authorization required
Troy Health, INC.2200Prior authorization required
Community Health Group2202Prior authorization required
Texas Independence Health Plan, INC.2202Prior authorization required
Tufts Health Public Plans, INC.2200Prior authorization required
Imperial Health Plan Of California, INC.2202Prior authorization required
Bridgeway Health Solutions Of Arizona, INC.2202Prior authorization required
Denver Health Medical Plan, INC.2202Prior authorization required
Senior Whole Health Of New York, INC.2202Prior authorization required
Nextblue Of North Dakota Insurance Company2200Prior authorization required
Healthpartners Insurance Company2200Prior authorization required
Missouri Care, Incorporated2200Prior authorization required
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
Elite Health Plan, INC.2202Prior authorization required
American Health Plan Of Iowa INC2202Prior authorization required
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2202Prior authorization required
Memorial Hermann Health Plan2202Prior authorization required
Excellus Health Plan Community Care LLC2202Prior authorization required
Georgia Assurance, INC.2202Prior authorization required
Visiting Nurse Association Of Central New York2202Prior authorization required
Trinity Health Plan Of Michigan INC2202Prior authorization required
Wyoblue Advantage INC2200Prior authorization required
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2202Prior authorization required
Align Senior Care Florida, INC.2202Prior authorization required
Hm Health Insurance Company2200Prior authorization required
Horizon Insurance Company2202Prior authorization required
Tsg Guard, INC.1101Prior authorization required
Local Initiative Health Authority For La County1101Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.1101Prior authorization required
Imperial County Local Health Authority1101Prior authorization required
Alameda Alliance For Health1100Prior authorization required
Independent Care Health Plan1101Prior authorization required
Itasca Medical Care1101Prior authorization required
HMO Minnesota1101Prior authorization required
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Wellpoint South Carolina, INC.1100Prior authorization required
Connecticare Insurance Company, INC.1101Prior authorization required
Independent Health Benefits Corporation1100Prior authorization required
Oklahoma Superior Select, INC.1101Prior authorization required
Allcare Health Plan, INC.1101Prior authorization required
Samaritan Health Plans, INC.1100Prior authorization required
Ghs Health Maintenance Organization, INC.1101Prior authorization required
Santa Clara County Health Authority1101Prior authorization required
Kern Health Systems1101Prior authorization required
Select Health Of South Carolina, INC.1101Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1100Prior authorization required
Paramount Insurance Company1101Prior authorization required
Absolute Total Care, INC.1101Prior authorization required
Orange County Health Authority1100Prior authorization required
Health Choice Arizona, INC.1101Prior authorization required
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1101Prior authorization required
San Joaquin County Health Commission1101Prior authorization required
Aids Healthcare Foundation1101Prior authorization required
Health Plan Of Careoregon, INC.1100Prior authorization required
Amerihealth Michigan, INC.1101Prior authorization required
Amerihealth Caritas Florida, INC.1101Prior authorization required
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1101Prior authorization required
Upmc Health Coverage, INC.1100Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba1101Prior authorization required
American Health Plan, INC.1101Prior authorization required
San Francisco Health Authority Dba San Francisco Health Plan1101Prior authorization required
Amerihealth Caritas North Carolina, INC.1101Prior authorization required
Horizon Healthcare Of New Jersey, INC.1101Prior authorization required
Hawaii Medical Service Association (Hmsa)1101Prior authorization required
Dignity Care Corporation1101Prior authorization required
Healthy Mississippi, INC.1101Prior authorization required
Inland Empire Health Plan1101Prior authorization required
West Virginia Senior Advantage, INC.1101Prior authorization required
Ventura County Medi-Cal Managed Care Commission1101Prior authorization required
Healthfirst Insurance Company, INC.1101Prior authorization required
American Health Plan Of Indiana INC1101Prior authorization required
American Health Plan Of Ms, INC.1101Prior authorization required
American Health Plan Of Pennsylvania INC1101Prior authorization required

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Haegarda 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.