Benefily

Does Medicare Part D cover Kerendia?

Kerendia appears on the Medicare Part D formularies of 317 payers in the corpus, across 5,496 plans. 228 payers require prior authorization on every covering plan, 2 on some plans, and 87 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 5,224 apply a quantity limit, on at least one Kerendia 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
UnitedHealthcare7317310731Prior authorization required
Aetna (CVS Health)65850658Varies by plan
Devoted Health41500415No prior authorization
Blue Cross Blue Shield (affiliate)2691990269Varies by plan
Centene (WellCare)19700197No prior authorization
Cigna1711710171Prior authorization required
Kaiser Permanente115000No prior authorization
SCAN Health Plan747400Prior authorization required
Elevance Health (Anthem)670067No prior authorization
Alignment Healthcare670067No prior authorization
Medco Containment Life And Medco Containment Ny6060060Prior authorization required
Molina Healthcare510051No prior authorization
Simply Healthcare Plans, INC.500050No prior authorization
Cariten Health Plan INC.4444044Prior authorization required
Uhc Of California4040040Prior authorization required
Priority Health3737037Prior authorization required
Careplus Health Plans, INC.3636036Prior authorization required
Bravo Health Pennsylvania, INC.3535035Prior authorization required
Preferred Care Partners, INC.3535035Prior authorization required
Zing Health Of Michigan, INC.330033No prior authorization
Health Care Service Corporation3131031Prior authorization required
Solis Health Plans, INC.2424024Prior authorization required
Sunshine State Health Plan, INC.240024No prior authorization
Freedom Health, INC.240024No prior authorization
Capital Advantage Insurance Company2323023Prior authorization required
Triple S Advantage, INC.2222022Prior authorization required
Physicians Health Choice Of Texas, LLC2222022Prior authorization required
Tufts Associated Health Maintenance Organization212100Prior authorization required
Mmm Healthcare, LLC200020No prior authorization
Mcs Advantage, INC.2020020Prior authorization required
Harmony Health Plan, INC.190019No prior authorization
Hcsc Insurance Services Company1818018Prior authorization required
California Physicians' Service1717017Prior authorization required
Medica Health Plans1717017Prior authorization required
Upmc Health Plan, INC.1717017Prior authorization required
Bluecross Blueshield Of Tennessee, INC.170017No prior authorization
Wellpoint Texas, INC.160016No prior authorization
Ultimate Health Plans, INC.1616016Prior authorization required
Excellus Health Plan, INC.161600Prior authorization required
Medical Mutual Of Ohio1616016Prior authorization required
Superior Healthplan, INC.150015No prior authorization
Florida Blue Medicare, INC.1515015Prior authorization required
Optimum Healthcare, INC.150015No prior authorization
Central Health Plan Of California, INC.150015No prior authorization
Blue Care Network Of Michigan1515015Prior authorization required
Selecthealth, INC.1414014Prior authorization required
Wellpoint Insurance Company140014No prior authorization
Peoples Health, INC.1313013Prior authorization required
Clover Health130013No prior authorization
Healthsun Health Plans, INC.130013No prior authorization
Prominence Healthfirst Of Texas131300Prior authorization required
Atrio Health Plans1212012Prior authorization required
Upmc Health Network, INC.1212012Prior authorization required
HMO Louisiana, INC.1212012Prior authorization required
Mount Carmel Health Plan, INC.110011No prior authorization
Pacificsource Community Health Plans1111011Prior authorization required
Community Insurance Company100010No prior authorization
Health Insurance Plan Of Greater New York1010010Prior authorization required
HMO Colorado, INC.100010No prior authorization
Quartz Health Plan Corporation1010010Prior authorization required
Compcare Health Services Insurance Corporation100010No prior authorization
Sanford Health Plan9909Prior authorization required
Allina Health And Aetna Insurance Company9009No prior authorization
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9909Prior authorization required
New York Quality Healthcare Corporation9009No prior authorization
Wellpoint Tennessee, INC.9009No prior authorization
Healthier New Jersey Insurance Company8808Prior authorization required
Meridian Health Plan Of Michigan, INC.8008No prior authorization
Healthpartners, INC.8800Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8008No prior authorization
Mvp Health Plan, INC.8008No prior authorization
Keystone Health Plan East, INC.8808Prior authorization required
Network Health Insurance Corporation8808Prior authorization required
Prominence Healthfirst8800Prior authorization required
Fallon Community Health Plan8808Prior authorization required
Peak Health Insurance Corporation8808Prior authorization required
Health Partners Plans, INC.8808Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8808Prior authorization required
Viva Health, INC.7007No prior authorization
Martin'S Point Generations Advantage, INC.7007No prior authorization
Wellpoint Health Plans, INC.7007No prior authorization
Astiva Health, INC.7707Prior authorization required
Bravo Health Mid-Atlantic, INC.7707Prior authorization required
Health Alliance Plan Of Michigan7707Prior authorization required
Medica Insurance Company7707Prior authorization required
Summacare INC.7707Prior authorization required
Keystone Health Plan Central, 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
Bluecross And Blueshield Of South Carolina7707Prior authorization required
Providence Health Assurance7707Prior authorization required
Alterwood Advantage, INC.7707Prior authorization required
Mass General Brigham Health Plan, INC6606Prior authorization required
Buckeye Community Health Plan, INC.6006No prior authorization
Christus Health Plan6006No prior authorization
Nebraska Total Care, INC.6006No prior authorization
Gold Kidney Of Florida INC6606Prior authorization required
Essence Healthcare, INC.6606Prior authorization required
Hometown Health Plan, INC.6606Prior authorization required
Presbyterian Health Plan6606Prior authorization required
Elderplan, INC.6006No prior authorization
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6006No prior authorization
Globalhealth, INC.6606Prior authorization required
Preferred Care Network, INC.6606Prior authorization required
Scott And White Health Plan6606Prior authorization required
Coordinated Care Of Washington, INC.5005No prior authorization
Chinese Community Health Plan5505Prior authorization required
Hopkins Health Advantage, INC.5005No prior authorization
Alliance Health And Life Insurance Company5505Prior authorization required
Sapphire Edge, INC.5505Prior authorization required
Independent Health Association, INC.5505Prior authorization required
Coordinated Care Corporation5005No prior authorization
Oh Chs Snp INC.5505Prior authorization required
Usable Mutual Insurance Company5005No prior authorization
Gold Kidney Of Arizona5505Prior authorization required
Meridian Health Plan Of Illinois, INC.5005No prior authorization
Sunflower State Health Plan, INC.5005No prior authorization
Prominence Healthfirst Of Florida INC5500Prior authorization required
Priority Health Choice, INC.5505Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5005No prior authorization
Hpmp Of Florida, INC.5005No prior authorization
Home State Health Plan, INC.4004No prior authorization
Baylor Scott & White Insurance Company4404Prior authorization required
Care N' Care Insurance Company Of North Carolina4404Prior authorization required
Health New England, INC.4404Prior authorization required
Pennsylvania Health & Wellness, INC.4004No prior authorization
The Health Plan Of West Virginia, INC.4404Prior authorization required
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4004No prior authorization
Qcc Insurance Company4404Prior 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
Sharp Health Plan4004No prior authorization
Gateway Health Plan, INC.4004No prior authorization
Capital Health Plan4404Prior authorization required
Boston Medical Center Health Plan, INC.4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4404Prior authorization required
Clever Care Of Golden State, INC.4004No prior authorization
Central Mass Health, LLC4404Prior authorization required
Ghs Insurance Company4404Prior authorization required
Thp Insurance Company4404Prior authorization required
Aspire Health Plan4404Prior authorization required
Amh Health, LLC4004No prior authorization
Dean Health Plan, INC.4404Prior authorization required
Quartz Health Plan Mn Corporation4404Prior authorization required
Medisun, INC.3303Prior authorization required
Metroplus Health Plan, INC.3003No prior authorization
Wellpoint West Virginia , INC.3003No prior authorization
Louisiana Health Service & Indemnity Company3303Prior authorization required
Eternalhealth, INC.3303Prior authorization required
Patrius Health, INC.3303Prior authorization required
Marquis Advantage, INC.3303Prior authorization required
Partners Insurance Company INC3303Prior authorization required
Mount Carmel Health Insurance Company3003No prior authorization
Community Care Health Plan Of Louisiana, INC.3003No prior authorization
Village Senior Services Corporation3303Prior authorization required
Trillium Community Health Plan, INC.3003No prior authorization
Senior Whole Health, LLC3003No prior authorization
Baycare Select Health Plans, INC.3303Prior authorization required
Cox Health Systems HMO INC3303Prior authorization required
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3003No prior authorization
Volunteer State Health Plan3003No prior authorization
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3300Prior authorization required
Procare Advantage, LLC3303Prior authorization required
Eternalhealth Of Arizona INC3303Prior authorization required
Paramount Care, INC.3003No prior authorization
Aultcare Health Insuring Corporation3303Prior authorization required
Mount Carmel Health Plan Of Idaho, INC.3003No prior authorization
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 Company3003No prior authorization
Amerihealth Insurance Company Of New Jersey3303Prior authorization required
Vns Choice3303Prior authorization required
Mercy Care3003No prior authorization
Usable HMO, INC.3003No prior authorization
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.3003No prior authorization
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
Carepartners Of Connecticut, INC.2200Prior authorization required
Amerihealth Caritas Vip Next, INC.2202Prior authorization required
Beshp, INC.2202Prior authorization required
Wellpoint Iowa, INC.2002No prior authorization
Commonwealth Care Alliance, INC.2002No prior authorization
Arkansas Superior Select, INC.2202Prior authorization required
Wellpoint Washington, INC.2002No prior authorization
Neighborhood Health Plan Of Rhode Island2002No prior authorization
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
Sentara Health Plans2202Prior authorization required
Verda Health Plan Of Arizona, INC.2202Prior authorization required
Partners Insurance Company Of New Jersey INC2202Prior authorization required
Sanford Health Plan Of Minnesota2202Prior 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.2002No prior authorization
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
Tufts Health Public Plans, INC.2200Prior authorization required
Imperial Health Plan Of California, INC.2202Prior authorization required
Bridgeway Health Solutions Of Arizona, INC.2002No prior authorization
Denver Health Medical Plan, INC.2202Prior authorization required
Community Health Plan Of Washington2202Prior authorization required
Senior Whole Health Of New York, INC.2002No prior authorization
Nextblue Of North Dakota Insurance Company2202Prior authorization required
Healthpartners Insurance Company2200Prior authorization required
Missouri Care, Incorporated2002No prior authorization
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 LLC2200Prior 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
Trinity Health Plan Of Michigan INC2002No prior authorization
Wyoblue Advantage INC2202Prior authorization required
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2002No prior authorization
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2202Prior authorization required
Hm Health Insurance Company2202Prior 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
Johns Hopkins Health Plan Of Virginia, INC.1001No prior authorization
Longevity Health Plan Of Florida, INC.1101Prior authorization required
Imperial County Local Health Authority1101Prior authorization required
Community Care Health Plan, INC.1000No prior authorization
Alameda Alliance For Health1101Prior authorization required
Independent Care Health Plan1101Prior authorization required
Itasca Medical Care1001No prior authorization
HMO Minnesota1101Prior authorization required
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Wellpoint South Carolina, INC.1001No prior authorization
Upper Peninsula Health Plan, LLC1101Prior authorization required
Connecticare Insurance Company, INC.1001No prior authorization
Independent Health Benefits Corporation1101Prior 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
Paramount Insurance Company1001No prior authorization
Absolute Total Care, INC.1001No prior authorization
Longevity Health Plan Of North Carolina, INC.1101Prior authorization required
Orange County Health Authority1101Prior authorization required
Health Choice Arizona, INC.1001No prior authorization
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
Horizon Healthcare Of New Jersey, INC.1101Prior authorization required
Longevity Health Plan Of New York, INC.1101Prior authorization required
Hawaii Medical Service Association (Hmsa)1001No prior authorization
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
Longevity Health Plan Of Illinois, INC.1101Prior authorization required
Ventura County Medi-Cal Managed Care Commission1101Prior authorization required
Healthfirst Insurance Company, INC.1001No prior authorization
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 Kerendia 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.