Does Medicare Part D cover Phyrago?
Phyrago appears on the Medicare Part D formularies of 42 payers in the corpus, across 1,232 plans. 41 payers require prior authorization on every covering plan, 0 on some plans, and 1 on none.
Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 1,221 apply a quantity limit, on at least one Phyrago 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
| Payer | Plans covering | Require prior auth | Step therapy | Quantity limit | Status |
|---|---|---|---|---|---|
| UnitedHealthcare | 731 | 731 | 0 | 731 | Prior authorization required |
| Elevance Health (Anthem) | 65 | 65 | 0 | 65 | Prior authorization required |
| Blue Cross Blue Shield (affiliate) | 51 | 51 | 0 | 51 | Prior authorization required |
| Simply Healthcare Plans, INC. | 50 | 50 | 0 | 50 | Prior authorization required |
| Uhc Of California | 40 | 40 | 0 | 40 | Prior authorization required |
| Preferred Care Partners, INC. | 35 | 35 | 0 | 35 | Prior authorization required |
| Freedom Health, INC. | 24 | 24 | 0 | 24 | Prior authorization required |
| Physicians Health Choice Of Texas, LLC | 22 | 22 | 0 | 22 | Prior authorization required |
| Wellpoint Texas, INC. | 16 | 16 | 0 | 16 | Prior authorization required |
| Optimum Healthcare, INC. | 15 | 15 | 0 | 15 | Prior authorization required |
| Wellpoint Insurance Company | 14 | 14 | 0 | 14 | Prior authorization required |
| Peoples Health, INC. | 13 | 13 | 0 | 13 | Prior authorization required |
| Healthsun Health Plans, INC. | 13 | 13 | 0 | 13 | Prior authorization required |
| Aetna (CVS Health) | 10 | 10 | 0 | 0 | Prior authorization required |
| Community Insurance Company | 10 | 10 | 0 | 10 | Prior authorization required |
| HMO Colorado, INC. | 10 | 10 | 0 | 10 | Prior authorization required |
| Compcare Health Services Insurance Corporation | 10 | 10 | 0 | 10 | Prior authorization required |
| Geisinger Health Plan | 9 | 9 | 0 | 9 | Prior authorization required |
| Wellpoint Tennessee, INC. | 9 | 9 | 0 | 9 | Prior authorization required |
| Keystone Health Plan East, INC. | 8 | 8 | 0 | 8 | Prior authorization required |
| Health Partners Plans, INC. | 8 | 8 | 0 | 8 | Prior authorization required |
| Wellpoint Health Plans, INC. | 7 | 7 | 0 | 7 | Prior authorization required |
| Providence Health Assurance | 7 | 7 | 0 | 7 | Prior authorization required |
| Presbyterian Health Plan | 6 | 6 | 0 | 6 | Prior authorization required |
| Preferred Care Network, INC. | 6 | 6 | 0 | 6 | Prior authorization required |
| Health New England, INC. | 4 | 4 | 0 | 4 | Prior authorization required |
| Qcc Insurance Company | 4 | 4 | 0 | 4 | Prior authorization required |
| Amh Health, LLC | 4 | 4 | 0 | 4 | Prior authorization required |
| Wellpoint West Virginia , INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Partners Insurance Company INC | 3 | 3 | 0 | 3 | Prior authorization required |
| Community Care Health Plan Of Louisiana, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Wellpoint New Jersey, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Geisinger Indemnity Insurance Company | 3 | 3 | 0 | 3 | Prior authorization required |
| Amerihealth Insurance Company Of New Jersey | 3 | 3 | 0 | 3 | Prior authorization required |
| Arizona Physicians Ipa, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Wellpoint Iowa, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Wellpoint Washington, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Partners Insurance Company Of New Jersey INC | 2 | 2 | 0 | 2 | Prior authorization required |
| Missouri Care, Incorporated | 2 | 2 | 0 | 2 | Prior authorization required |
| Community Care Health Plan, INC. | 1 | 0 | 0 | 0 | No prior authorization |
| Wellpoint South Carolina, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Orange County Health Authority | 1 | 1 | 0 | 1 | Prior authorization required |
“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Phyrago product on its formulary carries that condition.
- 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.