Benefily

Does Medicare Part D cover Ingrezza?

Ingrezza appears on the Medicare Part D formularies of 228 payers in the corpus, across 2,625 plans. 227 payers require prior authorization on every covering plan, 1 on some plans, and 0 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 2,481 apply a quantity limit, on at least one Ingrezza 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
UnitedHealthcare6976970697Prior authorization required
Centene (WellCare)1971970197Prior authorization required
Cigna1711710171Prior authorization required
Blue Cross Blue Shield (affiliate)1171170117Prior authorization required
Kaiser Permanente1151600Varies by plan
Alignment Healthcare6767067Prior authorization required
Medco Containment Life And Medco Containment Ny6060060Prior authorization required
Elevance Health (Anthem)5252052Prior authorization required
Simply Healthcare Plans, INC.5050050Prior authorization required
Uhc Of California4040040Prior authorization required
Bravo Health Pennsylvania, INC.3535035Prior authorization required
Preferred Care Partners, INC.3535035Prior authorization required
Health Care Service Corporation3131031Prior authorization required
Solis Health Plans, INC.2424024Prior authorization required
Sunshine State Health Plan, INC.2424024Prior authorization required
Freedom Health, INC.2424024Prior authorization required
Physicians Health Choice Of Texas, LLC2222022Prior authorization required
Harmony Health Plan, INC.1919019Prior authorization required
Hcsc Insurance Services Company1818018Prior authorization required
Upmc Health Plan, INC.1717017Prior authorization required
Wellpoint Texas, INC.1616016Prior authorization required
Ultimate Health Plans, INC.1616016Prior authorization required
Excellus Health Plan, INC.1616016Prior authorization required
Superior Healthplan, INC.1515015Prior authorization required
Aetna (CVS Health)1515015Prior authorization required
Optimum Healthcare, INC.1515015Prior authorization required
Wellpoint Insurance Company1414014Prior authorization required
Florida Blue Medicare, INC.1313013Prior authorization required
Peoples Health, INC.1313013Prior authorization required
Healthsun Health Plans, INC.1313013Prior authorization required
Prominence Healthfirst Of Texas131300Prior authorization required
Atrio Health Plans1212012Prior authorization required
Upmc Health Network, INC.1212012Prior authorization required
HMO Louisiana, INC.1212012Prior authorization required
Community Insurance Company1010010Prior authorization required
Health Insurance Plan Of Greater New York1010010Prior authorization required
HMO Colorado, INC.1010010Prior authorization required
Quartz Health Plan Corporation1010010Prior authorization required
Compcare Health Services Insurance Corporation1010010Prior authorization required
Sanford Health Plan9909Prior authorization required
Geisinger Health Plan9909Prior authorization required
New York Quality Healthcare Corporation9909Prior authorization required
Meridian Health Plan Of Michigan, INC.8808Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8808Prior authorization required
Prominence Healthfirst8800Prior authorization required
Fallon Community Health Plan8808Prior authorization required
Peak Health Insurance Corporation8808Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8808Prior authorization required
Wellpoint Health Plans, INC.7707Prior authorization required
Astiva Health, INC.7707Prior authorization required
Bravo Health Mid-Atlantic, INC.7707Prior authorization required
Summacare INC.7707Prior authorization required
Champion Health Plan Of California INC7707Prior authorization required
Essence Healthcare PPO, INC.7707Prior authorization required
Champion Health Plan Of Nevada, INC.7707Prior authorization required
Alterwood Advantage, INC.7707Prior authorization required
Buckeye Community Health Plan, INC.6606Prior authorization required
Nebraska Total Care, INC.6606Prior authorization required
Gold Kidney Of Florida INC6606Prior authorization required
Essence Healthcare, INC.6606Prior authorization required
Hometown Health Plan, INC.6606Prior authorization required
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Globalhealth, INC.6606Prior authorization required
Preferred Care Network, INC.6606Prior authorization required
Bluecross And Blueshield Of South Carolina6606Prior authorization required
Scott And White Health Plan6606Prior authorization required
Coordinated Care Of Washington, INC.5505Prior authorization required
Chinese Community Health Plan5505Prior authorization required
Sapphire Edge, INC.5505Prior authorization required
Coordinated Care Corporation5505Prior authorization required
Oh Chs Snp INC.5505Prior authorization required
Gold Kidney Of Arizona5505Prior authorization required
Meridian Health Plan Of Illinois, INC.5505Prior authorization required
Wellpoint Tennessee, INC.5505Prior authorization required
Sunflower State Health Plan, INC.5505Prior authorization required
Prominence Healthfirst Of Florida INC5500Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5505Prior authorization required
Home State Health Plan, INC.4404Prior authorization required
Baylor Scott & White Insurance Company4404Prior authorization required
Care N' Care Insurance Company Of North Carolina4404Prior authorization required
Pennsylvania Health & Wellness, INC.4404Prior authorization required
The Health Plan Of West Virginia, INC.4404Prior authorization required
Communitycare Government Programs, INC.4404Prior authorization required
Leon Health, INC.4404Prior authorization required
Verda Health Plan Of Texas INC4404Prior authorization required
Security Health Plan Of Wisconsin, INC.4404Prior authorization required
Gateway Health Plan, INC.4404Prior authorization required
Capital Health Plan4404Prior authorization required
Boston Medical Center Health Plan, INC.4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4404Prior authorization required
Ghs Insurance Company4404Prior authorization required
Thp Insurance Company4404Prior authorization required
Amh Health, LLC4404Prior authorization required
Dean Health Plan, INC.4404Prior authorization required
Quartz Health Plan Mn Corporation4404Prior authorization required
Medisun, INC.3303Prior authorization required
Louisiana Health Service & Indemnity Company3303Prior authorization required
Eternalhealth, INC.3303Prior authorization required
Patrius Health, INC.3303Prior authorization required
Marquis Advantage, INC.3303Prior authorization required
Community Care Health Plan Of Louisiana, INC.3303Prior authorization required
Village Senior Services Corporation3303Prior authorization required
Trillium Community Health Plan, INC.3303Prior 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.3303Prior 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
Eternalhealth Of Arizona INC3303Prior authorization required
Aultcare Health Insuring Corporation3300Prior authorization required
Geisinger Indemnity Insurance Company3303Prior authorization required
Simpra Advantage, INC.3303Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3303Prior authorization required
Provider Partners Health Plan Of North Carolina3303Prior authorization required
Provider Partners Health Plan Of Indiana3303Prior authorization required
Celtic Insurance Company3303Prior authorization required
Vns Choice3303Prior authorization required
Mclaren Health Plan, INC.3303Prior authorization required
Liberty Advantage, LLC3303Prior authorization required
Southeastern Indiana Health Organization, INC.3303Prior authorization required
Central Mass Health, LLC3303Prior authorization required
Managed Health Services Insurance CORP.3303Prior authorization required
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3303Prior authorization required
Hamaspik, INC.2202Prior authorization required
Arizona Physicians Ipa, INC.2202Prior authorization required
Ks Plan Administrators, LLC2202Prior authorization required
Amerihealth Caritas Vip Next, INC.2202Prior authorization required
Beshp, INC.2202Prior authorization required
Wellpoint Iowa, INC.2202Prior authorization required
Wellpoint West Virginia , INC.2202Prior authorization required
Arkansas Superior Select, INC.2202Prior authorization required
Wellpoint Washington, INC.2202Prior 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 Alliance2202Prior authorization required
Verda Health Plan Of Arizona, INC.2202Prior authorization required
Sanford Health Plan Of Minnesota2202Prior authorization required
Capital Advantage Insurance Company2202Prior authorization required
Keystone Health Plan Central, INC.2202Prior 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, INC2202Prior 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.2202Prior authorization required
Community Health Group2202Prior authorization required
Banner - University Care Advantage2202Prior authorization required
Texas Independence Health Plan, INC.2202Prior 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
Missouri Care, Incorporated2202Prior authorization required
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
Elite Health Plan, INC.2202Prior authorization required
American Health Plan Of Iowa INC2202Prior authorization required
Elderserve Health, INC.2202Prior authorization required
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2202Prior authorization required
Memorial Hermann Health Plan2202Prior authorization required
Good Samaritan Insurance Plan Of Nebraska, INC.2202Prior authorization required
Excellus Health Plan Community Care LLC2202Prior authorization required
Group Health Cooperative Of Eau Claire2202Prior authorization required
Georgia Assurance, INC.2202Prior authorization required
Caresource Georgia CO.2202Prior authorization required
Visiting Nurse Association Of Central New York2202Prior authorization required
Community Health Choice Texas, INC.2202Prior authorization required
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2202Prior authorization required
Horizon Insurance Company2202Prior authorization required
Longevity Health Plan Of Colorado, INC.1101Prior authorization required
Tsg Guard, INC.1101Prior authorization required
Local Initiative Health Authority For La County1101Prior authorization required
Longevity Health Plan Of Florida, INC.1101Prior authorization required
Imperial County Local Health Authority1101Prior authorization required
Alameda Alliance For Health1101Prior authorization required
HMO Minnesota1101Prior authorization required
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Upper Peninsula Health Plan, LLC1101Prior authorization required
Oklahoma Superior Select, INC.1101Prior authorization required
Provider Partners Health Plan Of Illinois1101Prior authorization required
Allcare Health Plan, INC.1101Prior authorization required
Samaritan Health Plans, INC.1101Prior authorization required
Ghs Health Maintenance Organization, INC.1101Prior authorization required
Santa Clara County Health Authority1101Prior authorization required
Provider Partners Health Plan Of Texas, INC.1101Prior authorization required
Kern Health Systems1101Prior authorization required
Hap Caresource1101Prior authorization required
Select Health Of South Carolina, INC.1101Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1101Prior authorization required
Absolute Total Care, INC.1101Prior authorization required
Longevity Health Plan Of North Carolina, INC.1101Prior authorization required
Orange County Health Authority1101Prior authorization required
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1101Prior authorization required
San Joaquin County Health Commission1101Prior authorization required
Banner Health Plan, INC.1101Prior authorization required
Aids Healthcare Foundation1101Prior authorization required
Health Plan Of Careoregon, INC.1101Prior authorization required
Alohacare1101Prior authorization required
San Mateo Health Commission1101Prior authorization required
Amerihealth Michigan, INC.1101Prior authorization required
Amerihealth Caritas Florida, INC.1101Prior authorization required
Caresource Ohio, INC.1101Prior authorization required
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1101Prior authorization required
Upmc Health Coverage, INC.1101Prior authorization required
Provider Partners Health Plan Of Kentucky1101Prior authorization required
Longevity Health Plan Of Michigan, INC.1101Prior 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
Longevity Health Plan Of New York, INC.1101Prior authorization required
Dignity Care Corporation1101Prior authorization required
Inland Empire Health Plan1101Prior authorization required
West Virginia Senior Advantage, INC.1101Prior authorization required
Longevity Health Plan Of Illinois, INC.1101Prior authorization required
Ventura County Medi-Cal Managed Care Commission1101Prior 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 Ingrezza 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.