Does Medicare Part D cover Pyzchiva?
Pyzchiva appears on the Medicare Part D formularies of 100 payers in the corpus, across 1,807 plans. 100 payers require prior authorization on every covering plan, 0 on some plans, and 0 on none.
Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 1,807 apply a quantity limit, on at least one Pyzchiva 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 |
|---|---|---|---|---|---|
| Aetna (CVS Health) | 643 | 643 | 0 | 643 | Prior authorization required |
| Devoted Health | 415 | 415 | 0 | 415 | Prior authorization required |
| Blue Cross Blue Shield (affiliate) | 90 | 90 | 0 | 90 | Prior authorization required |
| Alignment Healthcare | 67 | 67 | 0 | 67 | Prior authorization required |
| Molina Healthcare | 51 | 51 | 0 | 51 | Prior authorization required |
| Zing Health Of Michigan, INC. | 33 | 33 | 0 | 33 | Prior authorization required |
| Health Care Service Corporation | 31 | 31 | 0 | 31 | Prior authorization required |
| Solis Health Plans, INC. | 24 | 24 | 0 | 24 | Prior authorization required |
| Capital Advantage Insurance Company | 23 | 23 | 0 | 23 | Prior authorization required |
| Hcsc Insurance Services Company | 18 | 18 | 0 | 18 | Prior authorization required |
| Medica Health Plans | 17 | 17 | 0 | 17 | Prior authorization required |
| Upmc Health Plan, INC. | 17 | 17 | 0 | 17 | Prior authorization required |
| Medical Mutual Of Ohio | 16 | 16 | 0 | 16 | Prior authorization required |
| Central Health Plan Of California, INC. | 15 | 15 | 0 | 15 | Prior authorization required |
| Selecthealth, INC. | 14 | 14 | 0 | 14 | Prior authorization required |
| Florida Blue Medicare, INC. | 13 | 13 | 0 | 13 | Prior authorization required |
| Clover Health | 13 | 13 | 0 | 13 | Prior authorization required |
| Upmc Health Network, INC. | 12 | 12 | 0 | 12 | Prior authorization required |
| HMO Louisiana, INC. | 12 | 12 | 0 | 12 | Prior authorization required |
| Mount Carmel Health Plan, INC. | 11 | 11 | 0 | 11 | Prior authorization required |
| Pacificsource Community Health Plans | 11 | 11 | 0 | 11 | Prior authorization required |
| Health Insurance Plan Of Greater New York | 10 | 10 | 0 | 10 | Prior authorization required |
| Allina Health And Aetna Insurance Company | 9 | 9 | 0 | 9 | Prior authorization required |
| Healthier New Jersey Insurance Company | 8 | 8 | 0 | 8 | Prior authorization required |
| Mvp Health Plan, INC. | 8 | 8 | 0 | 8 | Prior authorization required |
| Medco Containment Life & Medco Containment Ny & Health Care | 8 | 8 | 0 | 8 | Prior authorization required |
| Viva Health, INC. | 7 | 7 | 0 | 7 | Prior authorization required |
| Martin'S Point Generations Advantage, INC. | 7 | 7 | 0 | 7 | Prior authorization required |
| Medica Insurance Company | 7 | 7 | 0 | 7 | Prior authorization required |
| Keystone Health Plan Central, INC. | 7 | 7 | 0 | 7 | Prior authorization required |
| Essence Healthcare PPO, INC. | 7 | 7 | 0 | 7 | Prior authorization required |
| Providence Health Assurance | 7 | 7 | 0 | 7 | Prior authorization required |
| Christus Health Plan | 6 | 6 | 0 | 6 | Prior authorization required |
| Essence Healthcare, INC. | 6 | 6 | 0 | 6 | Prior authorization required |
| Elderplan, INC. | 6 | 6 | 0 | 6 | Prior authorization required |
| Connecticare, INC. | 6 | 6 | 0 | 6 | Prior authorization required |
| Scott And White Health Plan | 6 | 6 | 0 | 6 | Prior authorization required |
| Hopkins Health Advantage, INC. | 5 | 5 | 0 | 5 | Prior authorization required |
| Sapphire Edge, INC. | 5 | 5 | 0 | 5 | Prior authorization required |
| Usable Mutual Insurance Company | 5 | 5 | 0 | 5 | Prior authorization required |
| Hpmp Of Florida, INC. | 5 | 5 | 0 | 5 | Prior authorization required |
| Baylor Scott & White Insurance Company | 4 | 4 | 0 | 4 | Prior authorization required |
| The Health Plan Of West Virginia, INC. | 4 | 4 | 0 | 4 | Prior authorization required |
| Hawaii Medical Service Association | 4 | 4 | 0 | 4 | Prior authorization required |
| Sharp Health Plan | 4 | 4 | 0 | 4 | Prior authorization required |
| Capital Health Plan | 4 | 4 | 0 | 4 | Prior authorization required |
| Boston Medical Center Health Plan, INC. | 4 | 4 | 0 | 4 | Prior authorization required |
| Bluecross Blueshield Kansas Solutions, INC. | 4 | 4 | 0 | 4 | Prior authorization required |
| Clever Care Of Golden State, INC. | 4 | 4 | 0 | 4 | Prior authorization required |
| Central Mass Health, LLC | 4 | 4 | 0 | 4 | Prior authorization required |
| Ghs Insurance Company | 4 | 4 | 0 | 4 | Prior authorization required |
| Thp Insurance Company | 4 | 4 | 0 | 4 | Prior authorization required |
| Metroplus Health Plan, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Louisiana Health Service & Indemnity Company | 3 | 3 | 0 | 3 | Prior authorization required |
| Patrius Health, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Mount Carmel Health Insurance Company | 3 | 3 | 0 | 3 | Prior authorization required |
| Senior Whole Health, LLC | 3 | 3 | 0 | 3 | Prior authorization required |
| Paramount Care, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Mount Carmel Health Plan Of Idaho, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Mercy Care | 3 | 3 | 0 | 3 | Prior authorization required |
| Usable HMO, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Hamaspik, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Commonwealth Care Alliance, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Neighborhood Health Plan Of Rhode Island | 2 | 2 | 0 | 2 | Prior authorization required |
| Upmc For You, INC | 2 | 2 | 0 | 2 | Prior authorization required |
| Banner - University Care Advantage | 2 | 2 | 0 | 2 | Prior authorization required |
| Community Health Plan Of Washington | 2 | 2 | 0 | 2 | Prior authorization required |
| Senior Whole Health Of New York, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Elderserve Health, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Memorial Hermann Health Plan | 2 | 2 | 0 | 2 | Prior authorization required |
| Group Health Cooperative Of Eau Claire | 2 | 2 | 0 | 2 | Prior authorization required |
| Caresource Georgia CO. | 2 | 2 | 0 | 2 | Prior authorization required |
| Trinity Health Plan Of Michigan INC | 2 | 2 | 0 | 2 | Prior authorization required |
| Mount Carmel Health Plan Of New York, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Longevity Health Plan Of New Jersey Insurance Comp | 2 | 2 | 0 | 2 | Prior authorization required |
| Elevance Health (Anthem) | 2 | 2 | 0 | 2 | Prior authorization required |
| Horizon Insurance Company | 2 | 2 | 0 | 2 | Prior authorization required |
| Longevity Health Plan Of Colorado, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Johns Hopkins Health Plan Of Virginia, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Longevity Health Plan Of Florida, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Itasca Medical Care | 1 | 1 | 0 | 1 | Prior authorization required |
| HMO Minnesota | 1 | 1 | 0 | 1 | Prior authorization required |
| Upper Peninsula Health Plan, LLC | 1 | 1 | 0 | 1 | Prior authorization required |
| Connecticare Insurance Company, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Ghs Health Maintenance Organization, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Hap Caresource | 1 | 1 | 0 | 1 | Prior authorization required |
| Paramount Insurance Company | 1 | 1 | 0 | 1 | Prior authorization required |
| Longevity Health Plan Of North Carolina, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Health Choice Arizona, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Banner Health Plan, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Caresource Ohio, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Upmc Health Coverage, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Longevity Health Plan Of Michigan, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Horizon Healthcare Of New Jersey, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Longevity Health Plan Of New York, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Hawaii Medical Service Association (Hmsa) | 1 | 1 | 0 | 1 | Prior authorization required |
| Healthy Mississippi, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Longevity Health Plan Of Illinois, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Ventura County Medi-Cal Managed Care Commission | 1 | 1 | 0 | 1 | Prior authorization required |
| Healthfirst Insurance Company, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Pyzchiva 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.