Benefily
Sign inCreate account

Does Medicare Part D cover Lotemax?

Lotemax appears on the Medicare Part D formularies of 149 payers in the corpus, across 3,800 plans. 0 payers require prior authorization on every covering plan, 0 on some plans, and 149 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 242 apply a quantity limit, on at least one Lotemax 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
Humana817000No prior authorization
UnitedHealthcare697000No prior authorization
Aetna (CVS Health)628000No prior authorization
Devoted Health415000No prior authorization
Cigna171000No prior authorization
SCAN Health Plan74000No prior authorization
Molina Healthcare51000No prior authorization
Simply Healthcare Plans, INC.50000No prior authorization
Cariten Health Plan INC.44000No prior authorization
Uhc Of California40000No prior authorization
Careplus Health Plans, INC.36000No prior authorization
Bravo Health Pennsylvania, INC.35000No prior authorization
Preferred Care Partners, INC.35000No prior authorization
Zing Health Of Michigan, INC.33000No prior authorization
Blue Cross Blue Shield (affiliate)31000No prior authorization
Medco Containment Life And Medco Containment Ny27000No prior authorization
Physicians Health Choice Of Texas, LLC22000No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mmm Healthcare, LLC20000No prior authorization
Bluecross Blueshield Of Tennessee, INC.17000No prior authorization
Ultimate Health Plans, INC.160016No prior authorization
Central Health Plan Of California, INC.15000No prior authorization
Selecthealth, INC.140014No prior authorization
Peoples Health, INC.13000No prior authorization
Clover Health13000No prior authorization
Healthsun Health Plans, INC.13000No prior authorization
Prominence Healthfirst Of Texas13000No prior authorization
Atrio Health Plans120012No prior authorization
Mount Carmel Health Plan, INC.11000No prior authorization
Pacificsource Community Health Plans11000No prior authorization
Quartz Health Plan Corporation100010No prior authorization
Sanford Health Plan9009No prior authorization
Allina Health And Aetna Insurance Company9000No prior authorization
Mvp Health Plan, INC.8000No prior authorization
Keystone Health Plan East, INC.8000No prior authorization
Network Health Insurance Corporation8000No prior authorization
Prominence Healthfirst8000No prior authorization
Health Partners Plans, INC.8000No prior authorization
Viva Health, INC.7000No prior authorization
Martin'S Point Generations Advantage, INC.7000No prior authorization
Astiva Health, INC.7007No prior authorization
Bravo Health Mid-Atlantic, INC.7000No prior authorization
Summacare INC.7007No prior authorization
Champion Health Plan Of California INC7007No prior authorization
Champion Health Plan Of Nevada, INC.7007No prior authorization
Bluecross And Blueshield Of South Carolina7007No prior authorization
Providence Health Assurance7000No prior authorization
Alterwood Advantage, INC.7007No prior authorization
Mass General Brigham Health Plan, INC6000No prior authorization
Christus Health Plan6000No prior authorization
Gold Kidney Of Florida INC6006No prior authorization
Hometown Health Plan, INC.6006No prior authorization
Elderplan, INC.6000No prior authorization
Connecticare, INC.6000No prior authorization
Preferred Care Network, INC.6000No prior authorization
Chinese Community Health Plan5005No prior authorization
Hopkins Health Advantage, INC.5000No prior authorization
Oh Chs Snp INC.5005No prior authorization
Usable Mutual Insurance Company5000No prior authorization
Gold Kidney Of Arizona5005No prior authorization
Prominence Healthfirst Of Florida INC5000No prior authorization
Hpmp Of Florida, INC.5000No prior authorization
Care N' Care Insurance Company Of North Carolina4004No prior authorization
Health New England, INC.4004No prior authorization
Hawaii Medical Service Association4000No prior authorization
Qcc Insurance Company4000No prior authorization
Leon Health, INC.4004No prior authorization
Verda Health Plan Of Texas INC4004No prior authorization
Security Health Plan Of Wisconsin, INC.4004No prior authorization
Sharp Health Plan4000No prior authorization
Clever Care Of Golden State, INC.4000No prior authorization
Quartz Health Plan Mn Corporation4004No prior authorization
Medisun, INC.3003No prior authorization
Metroplus Health Plan, INC.3000No prior authorization
Eternalhealth, INC.3003No prior authorization
Partners Insurance Company INC3000No prior authorization
Mount Carmel Health Insurance Company3000No prior authorization
Village Senior Services Corporation3003No prior authorization
Senior Whole Health, LLC3000No prior authorization
Baycare Select Health Plans, INC.3003No prior authorization
Cox Health Systems HMO INC3003No prior authorization
Volunteer State Health Plan3000No prior authorization
Eternalhealth Of Arizona INC3003No prior authorization
Paramount Care, INC.3000No prior authorization
Aultcare Health Insuring Corporation3000No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3000No prior authorization
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
Amerihealth Insurance Company Of New Jersey3000No prior authorization
Vns Choice3003No prior authorization
Mercy Care3000No prior authorization
Usable HMO, INC.3000No prior authorization
Mclaren Health Plan, INC.3003No prior authorization
Southeastern Indiana Health Organization, INC.3003No prior authorization
Provider Partners Health Plan Of Missouri, INC.3003No prior authorization
Arizona Physicians Ipa, INC.2000No prior authorization
Ks Plan Administrators, LLC2002No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Beshp, INC.2002No prior authorization
Florida Blue Medicare, INC.2002No prior authorization
Commonwealth Care Alliance, INC.2000No prior authorization
Neighborhood Health Plan Of Rhode Island2000No prior authorization
Signature Advantage, LLC2002No prior authorization
Primewest Rural Mn Health Care Access Initiative2002No prior authorization
Verda Health Plan Of Arizona, INC.2002No prior authorization
Partners Insurance Company Of New Jersey INC2000No prior authorization
Sanford Health Plan Of Minnesota2002No prior authorization
New Century Health Plan, INC.2002No prior authorization
Community Health Group2002No prior authorization
Texas Independence Health Plan, INC.2002No prior authorization
Tufts Health Public Plans, INC.2000No 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.2000No prior authorization
Elite Health Plan, INC.2002No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2002No prior authorization
Visiting Nurse Association Of Central New York2002No prior authorization
Trinity Health Plan Of Michigan INC2000No prior authorization
Mount Carmel Health Plan Of New York, INC.2000No prior authorization
Elevance Health (Anthem)2000No prior authorization
Tsg Guard, INC.1001No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.1000No prior authorization
Imperial County Local Health Authority1001No prior authorization
Community Care Health Plan, INC.1000No prior authorization
Independent Care Health Plan1000No prior authorization
Itasca Medical Care1000No prior authorization
Connecticare Insurance Company, INC.1000No prior authorization
Provider Partners Health Plan Of Illinois1001No prior authorization
Allcare Health Plan, INC.1001No prior authorization
Samaritan Health Plans, INC.1001No prior authorization
Santa Clara County Health Authority1001No prior authorization
Provider Partners Health Plan Of Texas, INC.1001No prior authorization
Kern Health Systems1001No prior authorization
Paramount Insurance Company1000No prior authorization
Orange County Health Authority1001No prior authorization
Health Choice Arizona, INC.1000No 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
Alohacare1001No prior authorization
Provider Partners Health Plan Of Kentucky1001No prior authorization
Santa Barbara San Luis Obispo Regional Health Authority Dba1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1001No prior authorization
Hawaii Medical Service Association (Hmsa)1000No prior authorization
Healthy Mississippi, INC.1001No prior authorization
Inland Empire Health Plan1001No prior authorization
West Virginia Senior Advantage, INC.1001No prior authorization
Healthfirst Insurance Company, INC.1000No prior authorization

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