Benefily
Sign inCreate account

Does Medicare Part D cover Restasis?

Restasis appears on the Medicare Part D formularies of 152 payers in the corpus. 0 require prior authorization on every covering plan, 0 on some plans, and 152 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 authStatus
UnitedHealthcare7310No prior authorization
Aetna (CVS Health)6530No prior authorization
Devoted Health4150No prior authorization
Blue Cross Blue Shield (affiliate)2690No prior authorization
Elevance Health (Anthem)670No prior authorization
Alignment Healthcare670No prior authorization
Molina Healthcare510No prior authorization
Simply Healthcare Plans, INC.500No prior authorization
Uhc Of California400No prior authorization
Priority Health370No prior authorization
Preferred Care Partners, INC.350No prior authorization
Zing Health Of Michigan, INC.330No prior authorization
Health Care Service Corporation310No prior authorization
Solis Health Plans, INC.240No prior authorization
Capital Advantage Insurance Company230No prior authorization
Triple S Advantage, INC.220No prior authorization
Physicians Health Choice Of Texas, LLC220No prior authorization
Tufts Associated Health Maintenance Organization210No prior authorization
Mmm Healthcare, LLC200No prior authorization
Hcsc Insurance Services Company180No prior authorization
California Physicians' Service170No prior authorization
Bluecross Blueshield Of Tennessee, INC.170No prior authorization
Wellpoint Texas, INC.160No prior authorization
Ultimate Health Plans, INC.160No prior authorization
Excellus Health Plan, INC.160No prior authorization
Central Health Plan Of California, INC.150No prior authorization
Blue Care Network Of Michigan150No prior authorization
Wellpoint Insurance Company140No prior authorization
Florida Blue Medicare, INC.130No prior authorization
Peoples Health, INC.130No prior authorization
Clover Health130No prior authorization
Healthsun Health Plans, INC.130No prior authorization
Prominence Healthfirst Of Texas130No prior authorization
Mount Carmel Health Plan, INC.110No prior authorization
Community Insurance Company100No prior authorization
Health Insurance Plan Of Greater New York100No prior authorization
HMO Colorado, INC.100No prior authorization
Quartz Health Plan Corporation100No prior authorization
Compcare Health Services Insurance Corporation100No prior authorization
Sanford Health Plan90No prior authorization
Allina Health And Aetna Insurance Company90No prior authorization
Doctors Healthcare Plans, INC.90No prior authorization
Wellpoint Tennessee, INC.90No prior authorization
Healthier New Jersey Insurance Company80No prior authorization
Healthpartners, INC.80No prior authorization
Mvp Health Plan, INC.80No prior authorization
Keystone Health Plan East, INC.80No prior authorization
Network Health Insurance Corporation80No prior authorization
Prominence Healthfirst80No prior authorization
Fallon Community Health Plan80No prior authorization
Health Partners Plans, INC.80No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care80No prior authorization
Viva Health, INC.70No prior authorization
Martin'S Point Generations Advantage, INC.70No prior authorization
Wellpoint Health Plans, INC.70No prior authorization
Keystone Health Plan Central, INC.70No prior authorization
Bluecross And Blueshield Of South Carolina70No prior authorization
Providence Health Assurance70No prior authorization
Mass General Brigham Health Plan, INC60No prior authorization
Christus Health Plan60No prior authorization
Hometown Health Plan, INC.60No prior authorization
Presbyterian Health Plan60No prior authorization
Elderplan, INC.60No prior authorization
Connecticare, INC.60No prior authorization
Preferred Care Network, INC.60No prior authorization
Scott And White Health Plan60No prior authorization
Hopkins Health Advantage, INC.50No prior authorization
Sapphire Edge, INC.50No prior authorization
Usable Mutual Insurance Company50No prior authorization
Prominence Healthfirst Of Florida INC50No prior authorization
Priority Health Choice, INC.50No prior authorization
Hpmp Of Florida, INC.50No prior authorization
Baylor Scott & White Insurance Company40No prior authorization
Care N' Care Insurance Company Of North Carolina40No prior authorization
Health New England, INC.40No prior authorization
Hawaii Medical Service Association40No prior authorization
Qcc Insurance Company40No prior authorization
Security Health Plan Of Wisconsin, INC.40No prior authorization
Sharp Health Plan40No prior authorization
Gateway Health Plan, INC.40No prior authorization
Capital Health Plan40No prior authorization
Bluecross Blueshield Kansas Solutions, INC.40No prior authorization
Clever Care Of Golden State, INC.40No prior authorization
Central Mass Health, LLC40No prior authorization
Ghs Insurance Company40No prior authorization
Amh Health, LLC40No prior authorization
Quartz Health Plan Mn Corporation40No prior authorization
Medisun, INC.30No prior authorization
Metroplus Health Plan, INC.30No prior authorization
Wellpoint West Virginia , INC.30No prior authorization
Eternalhealth, INC.30No prior authorization
Patrius Health, INC.30No prior authorization
Partners Insurance Company INC30No prior authorization
Mount Carmel Health Insurance Company30No prior authorization
Community Care Health Plan Of Louisiana, INC.30No prior authorization
Senior Whole Health, LLC30No prior authorization
Wellpoint New Jersey, INC.30No prior authorization
Volunteer State Health Plan30No prior authorization
Capital District Physicians' Health Plan, INC.30No prior authorization
Eternalhealth Of Arizona INC30No prior authorization
Paramount Care, INC.30No prior authorization
Aultcare Health Insuring Corporation30No prior authorization
Mount Carmel Health Plan Of Idaho, INC.30No prior authorization
Provider Partners Health Plan Of Pennsylvania, INC30No prior authorization
Provider Partners Health Plan Of North Carolina30No prior authorization
Provider Partners Health Plan Of Indiana30No prior authorization
Amerihealth Insurance Company Of New Jersey30No prior authorization
Mercy Care30No prior authorization
Usable HMO, INC.30No prior authorization
Provider Partners Health Plan Of Missouri, INC.30No prior authorization
Hamaspik, INC.20No prior authorization
Arizona Physicians Ipa, INC.20No prior authorization
Ks Plan Administrators, LLC20No prior authorization
Carepartners Of Connecticut, INC.20No prior authorization
Beshp, INC.20No prior authorization
Wellpoint Iowa, INC.20No prior authorization
Commonwealth Care Alliance, INC.20No prior authorization
Wellpoint Washington, INC.20No prior authorization
Neighborhood Health Plan Of Rhode Island20No prior authorization
Partners Insurance Company Of New Jersey INC20No prior authorization
Sanford Health Plan Of Minnesota20No prior authorization
Tufts Health Public Plans, INC.20No prior authorization
Senior Whole Health Of New York, INC.20No prior authorization
Nextblue Of North Dakota Insurance Company20No prior authorization
Healthpartners Insurance Company20No prior authorization
Missouri Care, Incorporated20No prior authorization
Memorial Hermann Health Plan20No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.20No prior authorization
Excellus Health Plan Community Care LLC20No prior authorization
Trinity Health Plan Of Michigan INC20No prior authorization
Wyoblue Advantage INC20No prior authorization
Mount Carmel Health Plan Of New York, INC.20No prior authorization
Hm Health Insurance Company20No prior authorization
Horizon Insurance Company20No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.10No prior authorization
Community Care Health Plan, INC.10No prior authorization
Itasca Medical Care10No prior authorization
HMO Minnesota10No prior authorization
Wellpoint South Carolina, INC.10No prior authorization
Connecticare Insurance Company, INC.10No prior authorization
Provider Partners Health Plan Of Illinois10No prior authorization
Ghs Health Maintenance Organization, INC.10No prior authorization
Provider Partners Health Plan Of Texas, INC.10No prior authorization
Paramount Insurance Company10No prior authorization
Mcs Advantage, INC.10No prior authorization
Health Choice Arizona, INC.10No prior authorization
Alohacare10No prior authorization
Provider Partners Health Plan Of Kentucky10No prior authorization
Horizon Healthcare Of New Jersey, INC.10No prior authorization
Hawaii Medical Service Association (Hmsa)10No prior authorization
Ventura County Medi-Cal Managed Care Commission10No prior authorization
Healthfirst Insurance Company, INC.10No prior authorization

“Require prior auth” counts a plan when any Restasis product on its formulary needs authorization.

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.