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Does Medicare Part D cover Risperdal?

Risperdal appears on the Medicare Part D formularies of 35 payers in the corpus, across 1,406 plans. 2 payers require prior authorization on every covering plan, 0 on some plans, and 33 on none.

Beyond prior authorization: 22 covering plans require step therapy (another drug tried first) and 1,291 apply a quantity limit, on at least one Risperdal 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
Centene (WellCare)19700197No prior authorization
Kaiser Permanente115000No prior authorization
Cariten Health Plan INC.440044No prior authorization
Careplus Health Plans, INC.360036No prior authorization
Sunshine State Health Plan, INC.240024No prior authorization
Triple S Advantage, INC.2202222No prior authorization
Harmony Health Plan, INC.190019No prior authorization
Superior Healthplan, INC.150015No prior authorization
Aetna (CVS Health)100010No prior authorization
New York Quality Healthcare Corporation9009No prior authorization
Meridian Health Plan Of Michigan, INC.8008No prior authorization
American Progressive Life & Hlth Ins Company Of Ny8008No prior authorization
Keystone Health Plan East, INC.8008No prior authorization
Buckeye Community Health Plan, INC.6006No prior authorization
Nebraska Total Care, INC.6006No prior authorization
Coordinated Care Of Washington, INC.5005No prior authorization
Coordinated Care Corporation5005No prior authorization
Meridian Health Plan Of Illinois, INC.5005No prior authorization
Sunflower State Health Plan, INC.5005No prior authorization
Arkansas Health & Wellness Health Plan, INC.5005No prior authorization
Home State Health Plan, INC.4004No prior authorization
Health New England, INC.4004No prior authorization
Pennsylvania Health & Wellness, INC.4004No prior authorization
Qcc Insurance Company4004No prior authorization
Trillium Community Health Plan, INC.3003No prior authorization
Celtic Insurance Company3003No prior authorization
Amerihealth Insurance Company Of New Jersey3003No prior authorization
Managed Health Services Insurance CORP.3003No prior authorization
Hamaspik, INC.2202Prior authorization required
Selectcare Of Texas, INC.2002No prior authorization
Bridgeway Health Solutions Of Arizona, INC.2002No prior authorization
Independent Care Health Plan1001No prior authorization
Absolute Total Care, INC.1001No prior authorization
Mcs Advantage, INC.1101Prior authorization required

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