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Does Medicare Part D cover Lokelma?

Lokelma appears on the Medicare Part D formularies of 310 payers in the corpus, across 5,338 plans. 28 payers require prior authorization on every covering plan, 6 on some plans, and 276 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 3,259 apply a quantity limit, on at least one Lokelma 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
Humana81700817No prior authorization
UnitedHealthcare73100731No prior authorization
Aetna (CVS Health)65850641Varies by plan
Devoted Health415000No prior authorization
Blue Cross Blue Shield (affiliate)269960179Varies by plan
Centene (WellCare)197000No prior authorization
Cigna171000No prior authorization
Kaiser Permanente1151600Varies by plan
SCAN Health Plan74000No prior authorization
Elevance Health (Anthem)670065No prior authorization
Molina Healthcare51000No prior authorization
Simply Healthcare Plans, INC.500050No prior authorization
Cariten Health Plan INC.440044No prior authorization
Uhc Of California400040No prior authorization
Priority Health370037No prior authorization
Careplus Health Plans, INC.360036No prior authorization
Bravo Health Pennsylvania, INC.35000No prior authorization
Preferred Care Partners, INC.350035No prior authorization
Zing Health Of Michigan, INC.33000No prior authorization
Health Care Service Corporation31000No prior authorization
Solis Health Plans, INC.24000No prior authorization
Sunshine State Health Plan, INC.24000No prior authorization
Freedom Health, INC.240024No prior authorization
Capital Advantage Insurance Company23000No prior authorization
Triple S Advantage, INC.222200Prior authorization required
Physicians Health Choice Of Texas, LLC220022No prior authorization
Tufts Associated Health Maintenance Organization210021No prior authorization
Mmm Healthcare, LLC20000No prior authorization
Mcs Advantage, INC.20000No prior authorization
Harmony Health Plan, INC.19000No prior authorization
Hcsc Insurance Services Company18000No prior authorization
California Physicians' Service17000No prior authorization
Medica Health Plans17000No prior authorization
Upmc Health Plan, INC.170017No prior authorization
Bluecross Blueshield Of Tennessee, INC.17000No prior authorization
Wellpoint Texas, INC.160016No prior authorization
Ultimate Health Plans, INC.160016No prior authorization
Excellus Health Plan, INC.160016No prior authorization
Medical Mutual Of Ohio16000No prior authorization
Superior Healthplan, INC.15000No prior authorization
Florida Blue Medicare, INC.15200Varies by plan
Optimum Healthcare, INC.150015No prior authorization
Central Health Plan Of California, INC.15000No prior authorization
Blue Care Network Of Michigan150015No prior authorization
Selecthealth, INC.140014No prior authorization
Wellpoint Insurance Company140014No prior authorization
Peoples Health, INC.130013No prior authorization
Clover Health13000No prior authorization
Healthsun Health Plans, INC.130013No prior authorization
Prominence Healthfirst Of Texas130013No prior authorization
Atrio Health Plans12000No prior authorization
Upmc Health Network, INC.120012No prior authorization
HMO Louisiana, INC.12000No prior authorization
Mount Carmel Health Plan, INC.11000No prior authorization
Pacificsource Community Health Plans11000No prior authorization
Community Insurance Company100010No prior authorization
Health Insurance Plan Of Greater New York10000No prior authorization
HMO Colorado, INC.100010No prior authorization
Quartz Health Plan Corporation100010No prior authorization
Compcare Health Services Insurance Corporation100010No prior authorization
Sanford Health Plan9009No prior authorization
Allina Health And Aetna Insurance Company9009No prior authorization
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9909Prior authorization required
New York Quality Healthcare Corporation9000No prior authorization
Wellpoint Tennessee, INC.9009No prior authorization
Healthier New Jersey Insurance Company8000No prior authorization
Meridian Health Plan Of Michigan, INC.8000No prior authorization
Healthpartners, INC.8000No prior authorization
American Progressive Life & Hlth Ins Company Of Ny8000No prior authorization
Mvp Health Plan, INC.8000No prior authorization
Network Health Insurance Corporation8008No prior authorization
Prominence Healthfirst8008No prior authorization
Peak Health Insurance Corporation8808Prior authorization required
Health Partners Plans, INC.8008No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care8000No prior authorization
Viva Health, INC.7000No prior authorization
Martin'S Point Generations Advantage, INC.7000No prior authorization
Wellpoint Health Plans, INC.7007No prior authorization
Astiva Health, INC.7000No prior authorization
Bravo Health Mid-Atlantic, INC.7000No prior authorization
Health Alliance Plan Of Michigan7700Prior authorization required
Medica Insurance Company7000No prior authorization
Summacare INC.7000No prior authorization
Keystone Health Plan Central, INC.7000No prior authorization
Champion Health Plan Of California INC7000No prior authorization
Essence Healthcare PPO, INC.7000No prior authorization
Champion Health Plan Of Nevada, INC.7000No prior authorization
Bluecross And Blueshield Of South Carolina7007No prior authorization
Alterwood Advantage, INC.7000No prior authorization
Mass General Brigham Health Plan, INC6000No prior authorization
Buckeye Community Health Plan, INC.6000No prior authorization
Christus Health Plan6000No prior authorization
Nebraska Total Care, INC.6000No prior authorization
Gold Kidney Of Florida INC6000No prior authorization
Essence Healthcare, INC.6000No prior authorization
Hometown Health Plan, INC.6006No prior authorization
Elderplan, INC.6000No prior authorization
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6000No prior authorization
Globalhealth, INC.6000No prior authorization
Preferred Care Network, INC.6006No prior authorization
Scott And White Health Plan6000No prior authorization
Coordinated Care Of Washington, INC.5000No prior authorization
Chinese Community Health Plan5000No prior authorization
Hopkins Health Advantage, INC.5000No prior authorization
Alliance Health And Life Insurance Company5500Prior authorization required
Sapphire Edge, INC.5000No prior authorization
Independent Health Association, INC.5000No prior authorization
Coordinated Care Corporation5000No prior authorization
Oh Chs Snp INC.5000No prior authorization
Usable Mutual Insurance Company5000No prior authorization
Gold Kidney Of Arizona5000No prior authorization
Meridian Health Plan Of Illinois, INC.5000No prior authorization
Sunflower State Health Plan, INC.5000No prior authorization
Prominence Healthfirst Of Florida INC5005No prior authorization
Priority Health Choice, INC.5005No prior authorization
Arkansas Health & Wellness Health Plan, INC.5000No prior authorization
Hpmp Of Florida, INC.5000No prior authorization
Home State Health Plan, INC.4000No prior authorization
Baylor Scott & White Insurance Company4000No prior authorization
Care N' Care Insurance Company Of North Carolina4004No prior authorization
Health New England, INC.4004No prior authorization
Pennsylvania Health & Wellness, INC.4000No prior authorization
The Health Plan Of West Virginia, INC.4000No prior authorization
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4000No prior authorization
Keystone Health Plan East, INC.4000No prior authorization
Leon Health, INC.4004No prior authorization
Verda Health Plan Of Texas INC4000No prior authorization
Security Health Plan Of Wisconsin, INC.4004No prior authorization
Sharp Health Plan4000No prior authorization
Gateway Health Plan, INC.4004No prior authorization
Capital Health Plan4000No prior authorization
Boston Medical Center Health Plan, INC.4000No prior authorization
Bluecross Blueshield Kansas Solutions, INC.4000No prior authorization
Clever Care Of Golden State, INC.4000No prior authorization
Central Mass Health, LLC4000No prior authorization
Ghs Insurance Company4000No prior authorization
Thp Insurance Company4000No prior authorization
Aspire Health Plan4004No prior authorization
Amh Health, LLC4004No prior authorization
Dean Health Plan, INC.4404Prior authorization required
Quartz Health Plan Mn Corporation4004No prior authorization
Medisun, INC.3003No prior authorization
Metroplus Health Plan, INC.3000No prior authorization
Wellpoint West Virginia , INC.3003No prior authorization
Louisiana Health Service & Indemnity Company3000No prior authorization
Eternalhealth, INC.3003No prior authorization
Patrius Health, INC.3000No prior authorization
Marquis Advantage, INC.3103Varies by plan
Partners Insurance Company INC3003No prior authorization
Mount Carmel Health Insurance Company3000No prior authorization
Community Care Health Plan Of Louisiana, INC.3003No prior authorization
Village Senior Services Corporation3000No prior authorization
Trillium Community Health Plan, INC.3000No prior authorization
Senior Whole Health, LLC3000No prior authorization
Baycare Select Health Plans, INC.3000No prior authorization
Cox Health Systems HMO INC3000No prior authorization
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3003No prior authorization
Volunteer State Health Plan3000No prior authorization
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3003No prior authorization
Procare Advantage, LLC3303Prior authorization required
Eternalhealth Of Arizona INC3003No prior authorization
Paramount Care, INC.3000No prior authorization
Aultcare Health Insuring Corporation3003No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3000No prior authorization
Geisinger Indemnity Insurance Company3303Prior authorization required
Simpra Advantage, INC.3303Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3003No prior authorization
Provider Partners Health Plan Of North Carolina3003No prior authorization
Provider Partners Health Plan Of Indiana3003No prior authorization
Celtic Insurance Company3000No prior authorization
Vns Choice3000No prior authorization
Mercy Care3000No prior authorization
Usable HMO, INC.3000No prior authorization
Mclaren Health Plan, INC.3000No prior authorization
Liberty Advantage, LLC3303Prior authorization required
Southeastern Indiana Health Organization, INC.3000No prior authorization
Managed Health Services Insurance CORP.3000No prior authorization
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3003No prior authorization
Hamaspik, INC.2000No prior authorization
Arizona Physicians Ipa, INC.2002No prior authorization
Ks Plan Administrators, LLC2002No prior authorization
Carepartners Of Connecticut, INC.2002No prior authorization
Amerihealth Caritas Vip Next, INC.2000No prior authorization
Beshp, INC.2002No prior authorization
Wellpoint Iowa, INC.2002No prior authorization
Commonwealth Care Alliance, INC.2000No prior authorization
Arkansas Superior Select, INC.2000No prior authorization
Wellpoint Washington, INC.2002No prior authorization
Neighborhood Health Plan Of Rhode Island2000No prior authorization
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2002No prior authorization
Signature Advantage, LLC2000No prior authorization
Primewest Rural Mn Health Care Access Initiative2000No prior authorization
South Country Health Alliance2000No prior authorization
Sentara Health Plans2002No prior authorization
Verda Health Plan Of Arizona, INC.2000No prior authorization
Partners Insurance Company Of New Jersey INC2002No prior authorization
Sanford Health Plan Of Minnesota2002No prior authorization
Qcc Insurance Company2000No prior authorization
Nhc Advantage, LLC2202Prior authorization required
Vista Health Plan, INC.2000No prior authorization
American Health Plan Of Ut, INC.2002No prior authorization
Upmc For You, INC2002No prior authorization
American Health Plan Of Missouri, INC.2002No prior authorization
Selectcare Of Texas, INC.2000No prior authorization
New Century Health Plan, INC.2000No prior authorization
Troy Health, INC.2000No prior authorization
Community Health Group2000No prior authorization
Banner - University Care Advantage2000No prior authorization
Texas Independence Health Plan, INC.2000No prior authorization
Tufts Health Public Plans, INC.2002No prior authorization
Imperial Health Plan Of California, INC.2000No prior authorization
Bridgeway Health Solutions Of Arizona, INC.2000No prior authorization
Denver Health Medical Plan, INC.2000No prior authorization
Community Health Plan Of Washington2000No prior authorization
Senior Whole Health Of New York, INC.2000No prior authorization
Nextblue Of North Dakota Insurance Company2002No prior authorization
Healthpartners Insurance Company2000No prior authorization
Missouri Care, Incorporated2002No prior authorization
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
Elite Health Plan, INC.2000No prior authorization
American Health Plan Of Iowa INC2002No prior authorization
Elderserve Health, INC.2000No prior authorization
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2102Varies by plan
Memorial Hermann Health Plan2000No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2002No prior authorization
Excellus Health Plan Community Care LLC2002No prior authorization
Group Health Cooperative Of Eau Claire2000No prior authorization
Georgia Assurance, INC.2002No prior authorization
Caresource Georgia CO.2000No prior authorization
Visiting Nurse Association Of Central New York2000No prior authorization
Trinity Health Plan Of Michigan INC2000No prior authorization
Wyoblue Advantage INC2002No prior authorization
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2000No prior authorization
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2000No prior authorization
Hm Health Insurance Company2202Prior authorization required
Horizon Insurance Company2000No prior authorization
Longevity Health Plan Of Colorado, INC.1000No prior authorization
Tsg Guard, INC.1000No prior authorization
Local Initiative Health Authority For La County1101Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.1000No prior authorization
Longevity Health Plan Of Florida, INC.1000No prior authorization
Imperial County Local Health Authority1000No prior authorization
Community Care Health Plan, INC.1000No prior authorization
Alameda Alliance For Health1000No prior authorization
Independent Care Health Plan1001No prior authorization
Itasca Medical Care1000No prior authorization
HMO Minnesota1000No prior authorization
Amerihealth Caritas Louisiana, INC.1000No prior authorization
Wellpoint South Carolina, INC.1001No prior authorization
Upper Peninsula Health Plan, LLC1000No prior authorization
Connecticare Insurance Company, INC.1000No prior authorization
Independent Health Benefits Corporation1000No prior authorization
Oklahoma Superior Select, INC.1001No prior authorization
Provider Partners Health Plan Of Illinois1001No prior authorization
Allcare Health Plan, INC.1000No prior authorization
Samaritan Health Plans, INC.1001No prior authorization
Ghs Health Maintenance Organization, INC.1000No prior authorization
Santa Clara County Health Authority1000No prior authorization
Provider Partners Health Plan Of Texas, INC.1001No prior authorization
Kern Health Systems1000No prior authorization
Hap Caresource1000No prior authorization
Select Health Of South Carolina, INC.1000No prior authorization
Contra Costa County Medical Service Dba Contra Costa Health1000No prior authorization
Paramount Insurance Company1000No prior authorization
Absolute Total Care, INC.1000No prior authorization
Longevity Health Plan Of North Carolina, INC.1000No prior authorization
Orange County Health Authority1101Prior authorization required
Health Choice Arizona, INC.1000No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1000No prior authorization
San Joaquin County Health Commission1000No prior authorization
Banner Health Plan, INC.1000No prior authorization
Aids Healthcare Foundation1000No prior authorization
Health Plan Of Careoregon, INC.1101Prior authorization required
Alohacare1001No prior authorization
Amerihealth Michigan, INC.1000No prior authorization
Amerihealth Caritas Florida, INC.1000No prior authorization
Caresource Ohio, INC.1000No prior authorization
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1001No prior authorization
Upmc Health Coverage, INC.1001No prior authorization
Provider Partners Health Plan Of Kentucky1001No prior authorization
Longevity Health Plan Of Michigan, INC.1000No prior authorization
Santa Barbara San Luis Obispo Regional Health Authority Dba1000No prior authorization
American Health Plan, INC.1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1000No prior authorization
Amerihealth Caritas North Carolina, INC.1000No prior authorization
Horizon Healthcare Of New Jersey, INC.1000No prior authorization
Longevity Health Plan Of New York, INC.1000No prior authorization
Hawaii Medical Service Association (Hmsa)1000No prior authorization
Dignity Care Corporation1001No prior authorization
Healthy Mississippi, INC.1001No prior authorization
Inland Empire Health Plan1000No prior authorization
West Virginia Senior Advantage, INC.1000No prior authorization
Longevity Health Plan Of Illinois, INC.1000No prior authorization
Ventura County Medi-Cal Managed Care Commission1000No prior authorization
Healthfirst Insurance Company, INC.1000No prior authorization
American Health Plan Of Indiana INC1001No prior authorization
American Health Plan Of Ms, INC.1001No prior authorization
American Health Plan Of Pennsylvania INC1001No prior authorization

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