Benefily

Does Medicare Part D cover Mavyret?

Mavyret appears on the Medicare Part D formularies of 251 payers in the corpus, across 3,655 plans. 250 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 1,889 apply a quantity limit, on at least one Mavyret 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
UnitedHealthcare7317310731Prior authorization required
Aetna (CVS Health)65865805Prior authorization required
Devoted Health41541500Prior authorization required
Blue Cross Blue Shield (affiliate)2542540164Prior authorization required
Kaiser Permanente1151600Varies by plan
Elevance Health (Anthem)6666064Prior authorization required
Molina Healthcare515100Prior authorization required
Simply Healthcare Plans, INC.5050050Prior authorization required
Uhc Of California4040040Prior authorization required
Preferred Care Partners, INC.3535035Prior authorization required
Zing Health Of Michigan, INC.333300Prior authorization required
Health Care Service Corporation313100Prior authorization required
Solis Health Plans, INC.242400Prior authorization required
Freedom Health, INC.2424024Prior authorization required
Capital Advantage Insurance Company232300Prior authorization required
Triple S Advantage, INC.222200Prior authorization required
Physicians Health Choice Of Texas, LLC2222022Prior authorization required
Tufts Associated Health Maintenance Organization212100Prior authorization required
Mmm Healthcare, LLC2020020Prior authorization required
Mcs Advantage, INC.2020020Prior authorization required
Hcsc Insurance Services Company181800Prior authorization required
California Physicians' Service1717017Prior authorization required
Medica Health Plans1717017Prior authorization required
Upmc Health Plan, INC.1717017Prior authorization required
Bluecross Blueshield Of Tennessee, INC.1717017Prior authorization required
Ultimate Health Plans, INC.1616016Prior authorization required
Excellus Health Plan, INC.1616016Prior authorization required
Medical Mutual Of Ohio1616016Prior authorization required
Florida Blue Medicare, INC.151500Prior authorization required
Optimum Healthcare, INC.1515015Prior authorization required
Central Health Plan Of California, INC.151500Prior authorization required
Blue Care Network Of Michigan1515015Prior authorization required
Selecthealth, INC.1414014Prior authorization required
Peoples Health, INC.1313013Prior authorization required
Clover Health131300Prior authorization required
Healthsun Health Plans, INC.1313013Prior authorization required
Prominence Healthfirst Of Texas1313013Prior authorization required
Upmc Health Network, INC.1212012Prior authorization required
HMO Louisiana, INC.1212012Prior authorization required
Wellpoint Texas, INC.1111011Prior authorization required
Mount Carmel Health Plan, INC.111100Prior authorization required
Pacificsource Community Health Plans1111011Prior authorization required
Wellpoint Insurance Company1111011Prior authorization required
Community Insurance Company1010010Prior authorization required
Health Insurance Plan Of Greater New York101000Prior authorization required
Quartz Health Plan Corporation1010010Prior authorization required
Compcare Health Services Insurance Corporation1010010Prior authorization required
Sanford Health Plan9909Prior authorization required
Allina Health And Aetna Insurance Company9900Prior authorization required
Geisinger Health Plan9909Prior authorization required
Wellpoint Tennessee, INC.9909Prior authorization required
Healthier New Jersey Insurance Company8800Prior authorization required
Healthpartners, INC.8808Prior authorization required
Mvp Health Plan, INC.8800Prior authorization required
Keystone Health Plan East, INC.8808Prior authorization required
Network Health Insurance Corporation8808Prior authorization required
Prominence Healthfirst8808Prior 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 Care8800Prior authorization required
Viva Health, INC.7700Prior authorization required
Martin'S Point Generations Advantage, INC.7700Prior authorization required
Health Alliance Plan Of Michigan7707Prior authorization required
Medica Insurance Company7707Prior authorization required
Summacare INC.7707Prior authorization required
Keystone Health Plan Central, INC.7700Prior authorization required
Essence Healthcare PPO, INC.7707Prior authorization required
Bluecross And Blueshield Of South Carolina7707Prior authorization required
Providence Health Assurance7707Prior authorization required
Mass General Brigham Health Plan, INC6600Prior authorization required
Christus Health Plan6600Prior authorization required
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.6600Prior authorization required
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6600Prior authorization required
Preferred Care Network, INC.6606Prior authorization required
Scott And White Health Plan6600Prior authorization required
Hopkins Health Advantage, INC.5500Prior authorization required
Alliance Health And Life Insurance Company5505Prior authorization required
Sapphire Edge, INC.5500Prior authorization required
Independent Health Association, INC.5500Prior authorization required
Usable Mutual Insurance Company5500Prior authorization required
HMO Colorado, INC.5505Prior authorization required
Gold Kidney Of Arizona5505Prior authorization required
Prominence Healthfirst Of Florida INC5505Prior authorization required
Hpmp Of Florida, INC.5500Prior authorization required
Baylor Scott & White Insurance Company4400Prior authorization required
Care N' Care Insurance Company Of North Carolina4404Prior authorization required
Health New England, INC.4404Prior authorization required
The Health Plan Of West Virginia, INC.4404Prior authorization required
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4400Prior authorization required
Qcc Insurance Company4404Prior authorization required
Security Health Plan Of Wisconsin, INC.4404Prior authorization required
Sharp Health Plan4400Prior authorization required
Gateway Health Plan, INC.4404Prior authorization required
Capital Health Plan4400Prior authorization required
Boston Medical Center Health Plan, INC.4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4400Prior authorization required
Clever Care Of Golden State, INC.4400Prior authorization required
Central Mass Health, LLC4400Prior authorization required
Ghs Insurance Company4400Prior 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
Metroplus Health Plan, INC.3300Prior authorization required
Wellpoint West Virginia , INC.3303Prior authorization required
Louisiana Health Service & Indemnity Company3303Prior authorization required
Eternalhealth, INC.3303Prior authorization required
Patrius Health, INC.3300Prior authorization required
Marquis Advantage, INC.3303Prior authorization required
Partners Insurance Company INC3303Prior authorization required
Mount Carmel Health Insurance Company3300Prior authorization required
Community Care Health Plan Of Louisiana, INC.3303Prior authorization required
Senior Whole Health, LLC3300Prior authorization required
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3303Prior 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
Eternalhealth Of Arizona INC3303Prior authorization required
Paramount Care, INC.3300Prior authorization required
Aultcare Health Insuring Corporation3303Prior authorization required
Oh Chs Snp INC.3303Prior authorization required
Mount Carmel Health Plan Of Idaho, INC.3300Prior 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
Amerihealth Insurance Company Of New Jersey3303Prior authorization required
Mercy Care3300Prior authorization required
Usable HMO, INC.3300Prior authorization required
Liberty Advantage, LLC3303Prior authorization required
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3303Prior authorization required
Hamaspik, INC.2200Prior 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.2202Prior authorization required
Commonwealth Care Alliance, INC.2200Prior authorization required
Arkansas Superior Select, INC.2202Prior authorization required
Wellpoint Washington, INC.2202Prior authorization required
Neighborhood Health Plan Of Rhode Island2200Prior authorization required
Village Senior Services Corporation2202Prior authorization required
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2202Prior authorization required
Signature Advantage, LLC2202Prior authorization required
South Country Health Alliance2200Prior authorization required
Sentara Health Plans2202Prior 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
Troy Health, INC.2200Prior authorization required
Banner - University Care Advantage2202Prior authorization required
Texas Independence Health Plan, INC.2202Prior authorization required
Tufts Health Public Plans, INC.2200Prior authorization required
Vns Choice2202Prior authorization required
Community Health Plan Of Washington2202Prior authorization required
Senior Whole Health Of New York, INC.2200Prior authorization required
Nextblue Of North Dakota Insurance Company2202Prior authorization required
Healthpartners Insurance Company2202Prior authorization required
Missouri Care, Incorporated2202Prior authorization required
Pruitthealth Premier North Carolina, LLC2202Prior 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 Plan2200Prior 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
Trinity Health Plan Of Michigan INC2200Prior authorization required
Wyoblue Advantage INC2202Prior authorization required
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2200Prior authorization required
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 Company2200Prior 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.1100Prior authorization required
Wellpoint Health Plans, INC.1101Prior authorization required
Longevity Health Plan Of Florida, INC.1101Prior authorization required
Community Care Health Plan, INC.1100Prior authorization required
Alameda Alliance For Health1100Prior authorization required
Itasca Medical Care1100Prior authorization required
HMO Minnesota1100Prior authorization required
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Wellpoint South Carolina, INC.1101Prior authorization required
Upper Peninsula Health Plan, LLC1101Prior authorization required
Connecticare Insurance Company, INC.1100Prior authorization required
Independent Health Benefits Corporation1100Prior authorization required
Oklahoma Superior Select, INC.1101Prior authorization required
Provider Partners Health Plan Of Illinois1101Prior authorization required
Samaritan Health Plans, INC.1101Prior authorization required
Ghs Health Maintenance Organization, INC.1100Prior authorization required
Provider Partners Health Plan Of Texas, INC.1101Prior authorization required
Hap Caresource1101Prior authorization required
Select Health Of South Carolina, INC.1101Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1100Prior authorization required
Paramount Insurance Company1100Prior authorization required
Longevity Health Plan Of North Carolina, INC.1101Prior authorization required
Orange County Health Authority1101Prior authorization required
Health Choice Arizona, INC.1100Prior 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
American Health Plan, INC.1101Prior authorization required
Amerihealth Caritas North Carolina, INC.1101Prior authorization required
Horizon Healthcare Of New Jersey, INC.1100Prior authorization required
Longevity Health Plan Of New York, INC.1101Prior authorization required
Hawaii Medical Service Association (Hmsa)1100Prior authorization required
Dignity Care Corporation1101Prior authorization required
Healthy Mississippi, INC.1101Prior 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 Commission1100Prior authorization required
Healthfirst Insurance Company, INC.1100Prior 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 Mavyret 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.