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Does Medicare Part D cover Myrbetriq?

Myrbetriq appears on the Medicare Part D formularies of 221 payers in the corpus, across 4,425 plans. 0 payers require prior authorization on every covering plan, 0 on some plans, and 221 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 2,996 apply a quantity limit, on at least one Myrbetriq 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
UnitedHealthcare697000No prior authorization
Aetna (CVS Health)65800658No prior authorization
Devoted Health41500415No prior authorization
Blue Cross Blue Shield (affiliate)21500215No prior authorization
Cigna171000No prior authorization
SCAN Health Plan74000No prior authorization
Alignment Healthcare670067No prior authorization
Medco Containment Life And Medco Containment Ny60000No prior authorization
Molina Healthcare510051No prior authorization
Cariten Health Plan INC.440044No prior authorization
Uhc Of California40000No prior authorization
Priority Health370037No prior authorization
Careplus Health Plans, INC.360036No prior authorization
Bravo Health Pennsylvania, INC.35000No prior authorization
Preferred Care Partners, INC.35000No prior authorization
Zing Health Of Michigan, INC.330033No prior authorization
Health Care Service Corporation310031No prior authorization
Solis Health Plans, INC.240024No prior authorization
Capital Advantage Insurance Company230023No prior authorization
Triple S Advantage, INC.220022No prior authorization
Physicians Health Choice Of Texas, LLC22000No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mcs Advantage, INC.200020No prior authorization
Hcsc Insurance Services Company180018No prior authorization
California Physicians' Service170017No prior authorization
Upmc Health Plan, INC.170017No prior authorization
Ultimate Health Plans, INC.16000No prior authorization
Central Health Plan Of California, INC.150015No prior authorization
Blue Care Network Of Michigan150015No prior authorization
Selecthealth, INC.140014No prior authorization
Florida Blue Medicare, INC.130013No prior authorization
Peoples Health, INC.13000No prior authorization
Clover Health130013No prior authorization
Prominence Healthfirst Of Texas13000No prior authorization
Upmc Health Network, INC.120012No prior authorization
Mount Carmel Health Plan, INC.110011No prior authorization
Health Insurance Plan Of Greater New York100010No prior authorization
Quartz Health Plan Corporation10000No prior authorization
Sanford Health Plan9000No prior authorization
Allina Health And Aetna Insurance Company9009No prior authorization
Geisinger Health Plan9009No prior authorization
Doctors Healthcare Plans, INC.9009No prior authorization
Healthier New Jersey Insurance Company8008No prior authorization
Mvp Health Plan, INC.8008No prior authorization
Keystone Health Plan East, INC.8000No prior authorization
Prominence Healthfirst8000No prior authorization
Fallon Community Health Plan8000No prior authorization
Peak Health Insurance Corporation8008No prior authorization
Health Partners Plans, INC.8008No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care8008No prior authorization
Viva Health, INC.7007No prior authorization
Martin'S Point Generations Advantage, INC.7007No prior authorization
Bravo Health Mid-Atlantic, INC.7000No prior authorization
Summacare INC.7000No prior authorization
Keystone Health Plan Central, INC.7007No prior authorization
Champion Health Plan Of California INC7000No prior authorization
Champion Health Plan Of Nevada, INC.7000No prior authorization
Bluecross And Blueshield Of South Carolina7000No prior authorization
Providence Health Assurance7007No prior authorization
Alterwood Advantage, INC.7000No prior authorization
Mass General Brigham Health Plan, INC6006No prior authorization
Christus Health Plan6006No prior authorization
Gold Kidney Of Florida INC6000No prior authorization
Hometown Health Plan, INC.6000No prior authorization
Elderplan, INC.6006No prior authorization
Perennial Advantage Of Colorado, INC.6006No prior authorization
Connecticare, INC.6006No prior authorization
Globalhealth, INC.6000No prior authorization
Preferred Care Network, INC.6000No prior authorization
Scott And White Health Plan6006No prior authorization
Chinese Community Health Plan5000No prior authorization
Hopkins Health Advantage, INC.5005No prior authorization
Sapphire Edge, INC.5005No prior authorization
Oh Chs Snp INC.5000No prior authorization
Usable Mutual Insurance Company5005No prior authorization
Gold Kidney Of Arizona5000No prior authorization
Prominence Healthfirst Of Florida INC5000No prior authorization
Priority Health Choice, INC.5005No prior authorization
Hpmp Of Florida, INC.5005No prior authorization
Baylor Scott & White Insurance Company4004No prior authorization
Care N' Care Insurance Company Of North Carolina4000No prior authorization
Health New England, INC.4000No prior authorization
Communitycare Government Programs, INC.4004No prior authorization
Hawaii Medical Service Association4004No prior authorization
Qcc Insurance Company4000No prior authorization
Security Health Plan Of Wisconsin, INC.4000No prior authorization
Sharp Health Plan4004No prior authorization
Capital Health Plan4004No prior authorization
Bluecross Blueshield Kansas Solutions, INC.4004No prior authorization
Clever Care Of Golden State, INC.4004No prior authorization
Central Mass Health, LLC4004No prior authorization
Ghs Insurance Company4004No prior authorization
Dean Health Plan, INC.4004No prior authorization
Quartz Health Plan Mn Corporation4000No prior authorization
Medisun, INC.3000No prior authorization
Metroplus Health Plan, INC.3003No prior authorization
Eternalhealth, INC.3000No prior authorization
Patrius Health, INC.3003No prior authorization
Marquis Advantage, INC.3003No prior authorization
Partners Insurance Company INC3003No prior authorization
Mount Carmel Health Insurance Company3003No prior authorization
Village Senior Services Corporation3000No prior authorization
Senior Whole Health, LLC3003No prior authorization
Cox Health Systems HMO INC3000No prior authorization
Secur INC3003No prior authorization
Align Senior Care California INC.3003No prior authorization
Pruitthealth Premier, INC.3003No prior authorization
Procare Advantage, LLC3003No prior authorization
Eternalhealth Of Arizona INC3000No prior authorization
Paramount Care, INC.3003No prior authorization
Aultcare Health Insuring Corporation3003No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3003No prior authorization
Geisinger Indemnity Insurance Company3003No prior authorization
Simpra Advantage, INC.3003No prior authorization
Provider Partners Health Plan Of Pennsylvania, INC3000No prior authorization
Provider Partners Health Plan Of North Carolina3000No prior authorization
Provider Partners Health Plan Of Indiana3000No prior authorization
Amerihealth Insurance Company Of New Jersey3000No prior authorization
Vns Choice3000No prior authorization
Mercy Care3003No prior authorization
Usable HMO, INC.3003No prior authorization
Mclaren Health Plan, INC.3000No prior authorization
Liberty Advantage, LLC3003No prior authorization
Southeastern Indiana Health Organization, INC.3000No prior authorization
Perennial Advantage Of Ohio, INC.3003No prior authorization
Provider Partners Health Plan Of Missouri, INC.3000No prior authorization
Hamaspik, INC.2002No prior authorization
Arizona Physicians Ipa, INC.2000No prior authorization
Ks Plan Administrators, LLC2000No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Amerihealth Caritas Vip Next, INC.2002No prior authorization
Beshp, INC.2000No prior authorization
Commonwealth Care Alliance, INC.2002No prior authorization
Neighborhood Health Plan Of Rhode Island2002No prior authorization
Lifeworks Advantage, LLC2002No prior authorization
Kansas Superior Select, INC.2002No prior authorization
Primewest Rural Mn Health Care Access Initiative2000No prior authorization
South Country Health Alliance2002No prior authorization
Sentara Health Plans2002No prior authorization
Partners Insurance Company Of New Jersey INC2002No prior authorization
Sanford Health Plan Of Minnesota2000No prior authorization
Nhc Advantage, LLC2002No prior authorization
Vista Health Plan, INC.2002No 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
New Century Health Plan, INC.2000No prior authorization
Troy Health, INC.2002No prior authorization
Community Health Group2000No prior authorization
Texas Independence Health Plan, INC.2000No prior authorization
Tufts Health Public Plans, INC.2000No prior authorization
Imperial Health Plan Of California, INC.2000No prior authorization
Denver Health Medical Plan, INC.2000No prior authorization
Senior Whole Health Of New York, INC.2002No prior authorization
Nextblue Of North Dakota Insurance Company2002No prior authorization
Pruitthealth Premier North Carolina, LLC2002No prior authorization
American Health Plan Of Iowa INC2002No prior authorization
Align Senior Care Mi, LLC2002No prior authorization
Isnp Ventures, LLC2002No prior authorization
Memorial Hermann Health Plan2002No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2000No prior authorization
Georgia Assurance, INC.2002No prior authorization
Visiting Nurse Association Of Central New York2000No prior authorization
Trinity Health Plan Of Michigan INC2002No prior authorization
Wyoblue Advantage INC2002No prior authorization
Community Health Choice Texas, INC.2002No prior authorization
Mount Carmel Health Plan Of New York, INC.2002No prior authorization
Align Senior Care Florida, INC.2002No prior authorization
Elevance Health (Anthem)2002No prior authorization
Hm Health Insurance Company2002No prior authorization
Horizon Insurance Company2002No prior authorization
Tsg Guard, INC.1000No prior authorization
Local Initiative Health Authority For La County1001No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.1001No prior authorization
Imperial County Local Health Authority1000No prior authorization
Alameda Alliance For Health1001No prior authorization
Independent Care Health Plan1001No prior authorization
Itasca Medical Care1001No prior authorization
HMO Minnesota1001No prior authorization
Amerihealth Caritas Louisiana, INC.1001No prior authorization
Connecticare Insurance Company, INC.1001No prior authorization
Oklahoma Superior Select, INC.1001No prior authorization
Provider Partners Health Plan Of Illinois1000No prior authorization
Allcare Health Plan, INC.1000No prior authorization
Samaritan Health Plans, INC.1000No prior authorization
Ghs Health Maintenance Organization, INC.1001No prior authorization
Santa Clara County Health Authority1000No prior authorization
Provider Partners Health Plan Of Texas, INC.1000No prior authorization
Kern Health Systems1000No prior authorization
Select Health Of South Carolina, INC.1001No prior authorization
Contra Costa County Medical Service Dba Contra Costa Health1001No prior authorization
Paramount Insurance Company1001No prior authorization
Orange County Health Authority1001No prior authorization
Health Choice Arizona, INC.1001No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1000No prior authorization
San Joaquin County Health Commission1000No prior authorization
Aids Healthcare Foundation1000No prior authorization
Health Plan Of Careoregon, INC.1001No prior authorization
Alohacare1000No prior authorization
San Mateo Health Commission1001No prior authorization
Amerihealth Michigan, INC.1001No prior authorization
Amerihealth Caritas Florida, INC.1001No prior authorization
Lagniappe Advantage Insurance Company1001No prior authorization
American Health Plan Of Fl, INC.1001No prior authorization
Upmc Health Coverage, INC.1001No prior authorization
Provider Partners Health Plan Of Kentucky1000No 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.1001No prior authorization
Horizon Healthcare Of New Jersey, INC.1001No prior authorization
Hawaii Medical Service Association (Hmsa)1001No 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
Ventura County Medi-Cal Managed Care Commission1001No prior authorization
Healthfirst Insurance Company, INC.1001No 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 Myrbetriq 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.