Benefily

Does Medicare Part D cover Omnitrope?

Omnitrope appears on the Medicare Part D formularies of 167 payers in the corpus, across 2,375 plans. 167 payers require prior authorization on every covering plan, 0 on some plans, and 0 on none.

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
Humana81781700Prior authorization required
Centene (WellCare)19719700Prior authorization required
Blue Cross Blue Shield (affiliate)13513500Prior authorization required
Kaiser Permanente11511500Prior authorization required
Alignment Healthcare676700Prior authorization required
Elevance Health (Anthem)656500Prior authorization required
Simply Healthcare Plans, INC.505000Prior authorization required
Cariten Health Plan INC.444400Prior authorization required
Priority Health373700Prior authorization required
Careplus Health Plans, INC.363600Prior authorization required
Health Care Service Corporation313100Prior authorization required
Solis Health Plans, INC.242400Prior authorization required
Sunshine State Health Plan, INC.242400Prior authorization required
Freedom Health, INC.242400Prior authorization required
Capital Advantage Insurance Company232300Prior authorization required
Mcs Advantage, INC.202000Prior authorization required
Harmony Health Plan, INC.191900Prior authorization required
Hcsc Insurance Services Company181800Prior authorization required
California Physicians' Service171700Prior authorization required
Medica Health Plans171700Prior authorization required
Wellpoint Texas, INC.161600Prior authorization required
Excellus Health Plan, INC.161600Prior authorization required
Medical Mutual Of Ohio161600Prior authorization required
Superior Healthplan, INC.151500Prior authorization required
Florida Blue Medicare, INC.151500Prior authorization required
Optimum Healthcare, INC.151500Prior authorization required
Selecthealth, INC.141400Prior authorization required
Wellpoint Insurance Company141400Prior authorization required
Healthsun Health Plans, INC.131300Prior authorization required
HMO Louisiana, INC.121200Prior authorization required
Community Insurance Company101000Prior authorization required
Health Insurance Plan Of Greater New York101000Prior authorization required
HMO Colorado, INC.101000Prior authorization required
Compcare Health Services Insurance Corporation101000Prior authorization required
Doctors Healthcare Plans, INC.9900Prior authorization required
New York Quality Healthcare Corporation9900Prior authorization required
Wellpoint Tennessee, INC.9900Prior authorization required
Healthier New Jersey Insurance Company8800Prior authorization required
Meridian Health Plan Of Michigan, INC.8800Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8800Prior authorization required
Keystone Health Plan East, INC.8800Prior authorization required
Peak Health Insurance Corporation8800Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8800Prior authorization required
Wellpoint Health Plans, INC.7700Prior authorization required
Medica Insurance Company7700Prior authorization required
Keystone Health Plan Central, INC.7700Prior authorization required
Essence Healthcare PPO, INC.7700Prior authorization required
Providence Health Assurance7700Prior authorization required
Mass General Brigham Health Plan, INC6600Prior authorization required
Buckeye Community Health Plan, INC.6600Prior authorization required
Nebraska Total Care, INC.6600Prior authorization required
Essence Healthcare, INC.6600Prior authorization required
Presbyterian Health Plan6600Prior authorization required
Perennial Advantage Of Colorado, INC.6600Prior authorization required
Scott And White Health Plan6600Prior authorization required
Coordinated Care Of Washington, INC.5500Prior authorization required
Sapphire Edge, INC.5500Prior authorization required
Aetna (CVS Health)5500Prior authorization required
Coordinated Care Corporation5500Prior authorization required
Meridian Health Plan Of Illinois, INC.5500Prior authorization required
Sunflower State Health Plan, INC.5500Prior authorization required
Priority Health Choice, INC.5500Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5500Prior authorization required
Home State Health Plan, INC.4400Prior authorization required
Baylor Scott & White Insurance Company4400Prior authorization required
Pennsylvania Health & Wellness, INC.4400Prior authorization required
The Health Plan Of West Virginia, INC.4400Prior authorization required
Communitycare Government Programs, INC.4400Prior authorization required
Qcc Insurance Company4400Prior authorization required
Capital Health Plan4400Prior authorization required
Boston Medical Center Health Plan, INC.4400Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4400Prior authorization required
Central Mass Health, LLC4400Prior authorization required
Ghs Insurance Company4400Prior authorization required
Thp Insurance Company4400Prior authorization required
Amh Health, LLC4400Prior authorization required
Dean Health Plan, INC.4400Prior authorization required
Wellpoint West Virginia , INC.3300Prior authorization required
Louisiana Health Service & Indemnity Company3300Prior authorization required
Patrius Health, INC.3300Prior authorization required
Marquis Advantage, INC.3300Prior authorization required
Community Care Health Plan Of Louisiana, INC.3300Prior authorization required
Trillium Community Health Plan, INC.3300Prior authorization required
Secur INC3300Prior authorization required
Wellpoint New Jersey, INC.3300Prior authorization required
Align Senior Care California INC.3300Prior authorization required
Pruitthealth Premier, INC.3300Prior authorization required
Capital District Physicians' Health Plan, INC.3300Prior authorization required
Procare Advantage, LLC3300Prior authorization required
Aultcare Health Insuring Corporation3300Prior authorization required
Simpra Advantage, INC.3300Prior authorization required
Celtic Insurance Company3300Prior authorization required
Amerihealth Insurance Company Of New Jersey3300Prior authorization required
Liberty Advantage, LLC3300Prior authorization required
Managed Health Services Insurance CORP.3300Prior authorization required
Perennial Advantage Of Ohio, INC.3300Prior authorization required
Hamaspik, INC.2200Prior authorization required
Amerihealth Caritas Vip Next, INC.2200Prior authorization required
Wellpoint Iowa, INC.2200Prior authorization required
Wellpoint Washington, INC.2200Prior authorization required
Lifeworks Advantage, LLC2200Prior authorization required
Kansas Superior Select, INC.2200Prior authorization required
South Country Health Alliance2200Prior authorization required
Sentara Health Plans2200Prior authorization required
Nhc Advantage, LLC2200Prior authorization required
Vista Health Plan, INC.2200Prior authorization required
American Health Plan Of Ut, INC.2200Prior authorization required
American Health Plan Of Missouri, INC.2200Prior authorization required
Selectcare Of Texas, INC.2200Prior authorization required
Troy Health, INC.2200Prior authorization required
Banner - University Care Advantage2200Prior authorization required
Bridgeway Health Solutions Of Arizona, INC.2200Prior authorization required
Community Health Plan Of Washington2200Prior authorization required
Missouri Care, Incorporated2200Prior authorization required
Pruitthealth Premier North Carolina, LLC2200Prior authorization required
American Health Plan Of Iowa INC2200Prior authorization required
Elderserve Health, INC.2200Prior authorization required
Align Senior Care Mi, LLC2200Prior authorization required
Isnp Ventures, LLC2200Prior authorization required
Memorial Hermann Health Plan2200Prior authorization required
Excellus Health Plan Community Care LLC2200Prior authorization required
Group Health Cooperative Of Eau Claire2200Prior authorization required
Georgia Assurance, INC.2200Prior authorization required
Caresource Georgia CO.2200Prior authorization required
Community Health Choice Texas, INC.2200Prior authorization required
Align Senior Care Florida, INC.2200Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2200Prior authorization required
Hm Health Insurance Company2200Prior authorization required
Horizon Insurance Company2200Prior authorization required
Longevity Health Plan Of Colorado, INC.1100Prior authorization required
Local Initiative Health Authority For La County1100Prior authorization required
Longevity Health Plan Of Florida, INC.1100Prior authorization required
Community Care Health Plan, INC.1100Prior authorization required
Alameda Alliance For Health1100Prior authorization required
Independent Care Health Plan1100Prior authorization required
HMO Minnesota1100Prior authorization required
Amerihealth Caritas Louisiana, INC.1100Prior authorization required
Wellpoint South Carolina, INC.1100Prior authorization required
Upper Peninsula Health Plan, LLC1100Prior authorization required
Oklahoma Superior Select, INC.1100Prior authorization required
Samaritan Health Plans, INC.1100Prior authorization required
Ghs Health Maintenance Organization, INC.1100Prior authorization required
Hap Caresource1100Prior authorization required
Select Health Of South Carolina, INC.1100Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1100Prior authorization required
Absolute Total Care, INC.1100Prior authorization required
Longevity Health Plan Of North Carolina, INC.1100Prior authorization required
Orange County Health Authority1100Prior authorization required
Banner Health Plan, INC.1100Prior authorization required
Health Plan Of Careoregon, INC.1100Prior authorization required
Amerihealth Michigan, INC.1100Prior authorization required
Amerihealth Caritas Florida, INC.1100Prior authorization required
Caresource Ohio, INC.1100Prior authorization required
Lagniappe Advantage Insurance Company1100Prior authorization required
American Health Plan Of Fl, INC.1100Prior authorization required
Longevity Health Plan Of Michigan, INC.1100Prior authorization required
American Health Plan, INC.1100Prior authorization required
Amerihealth Caritas North Carolina, INC.1100Prior authorization required
Horizon Healthcare Of New Jersey, INC.1100Prior authorization required
Longevity Health Plan Of New York, INC.1100Prior authorization required
Dignity Care Corporation1100Prior authorization required
Healthy Mississippi, INC.1100Prior authorization required
Longevity Health Plan Of Illinois, INC.1100Prior authorization required
Ventura County Medi-Cal Managed Care Commission1100Prior authorization required
American Health Plan Of Indiana INC1100Prior authorization required
American Health Plan Of Ms, INC.1100Prior authorization required
American Health Plan Of Pennsylvania INC1100Prior authorization required

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