Benefily
Sign inCreate account

Does Medicare Part D cover Subvenite?

Subvenite appears on the Medicare Part D formularies of 304 payers in the corpus, across 5,466 plans. 98 payers require prior authorization on every covering plan, 2 on some plans, and 204 on none.

Beyond prior authorization: 679 covering plans require step therapy (another drug tried first) and 170 apply a quantity limit, on at least one Subvenite 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
Humana817000No prior authorization
UnitedHealthcare731000No prior authorization
Aetna (CVS Health)65864175Varies by plan
Devoted Health41504150No prior authorization
Blue Cross Blue Shield (affiliate)26929160Varies by plan
Centene (WellCare)197000No prior authorization
Cigna171000No prior authorization
Kaiser Permanente115000No prior authorization
SCAN Health Plan74000No prior authorization
Elevance Health (Anthem)67020No prior authorization
Alignment Healthcare67000No prior authorization
Medco Containment Life And Medco Containment Ny60000No prior authorization
Molina Healthcare510510No prior authorization
Simply Healthcare Plans, INC.50000No prior authorization
Cariten Health Plan INC.44000No prior authorization
Uhc Of California40000No prior authorization
Priority Health373700Prior authorization required
Careplus Health Plans, INC.36000No prior authorization
Bravo Health Pennsylvania, INC.35000No prior authorization
Preferred Care Partners, INC.35000No prior authorization
Zing Health Of Michigan, INC.330330No prior authorization
Health Care Service Corporation31000No prior authorization
Solis Health Plans, INC.24000No prior authorization
Sunshine State Health Plan, INC.24000No prior authorization
Freedom Health, INC.24000No prior authorization
Capital Advantage Insurance Company23000No prior authorization
Triple S Advantage, INC.22000No prior authorization
Physicians Health Choice Of Texas, LLC22000No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mmm Healthcare, LLC20000No prior authorization
Mcs Advantage, INC.202000Prior authorization required
Harmony Health Plan, INC.19000No prior authorization
Hcsc Insurance Services Company18000No prior authorization
California Physicians' Service1717017Prior authorization required
Medica Health Plans17000No prior authorization
Upmc Health Plan, INC.1717017Prior authorization required
Bluecross Blueshield Of Tennessee, INC.170017No prior authorization
Wellpoint Texas, INC.16000No prior authorization
Ultimate Health Plans, INC.16000No prior authorization
Excellus Health Plan, INC.16000No prior authorization
Medical Mutual Of Ohio16000No prior authorization
Superior Healthplan, INC.15000No prior authorization
Florida Blue Medicare, INC.15002No prior authorization
Optimum Healthcare, INC.15000No prior authorization
Central Health Plan Of California, INC.150150No prior authorization
Blue Care Network Of Michigan151500Prior authorization required
Wellpoint Insurance Company14000No prior authorization
Peoples Health, INC.13000No prior authorization
Clover Health130130No prior authorization
Healthsun Health Plans, INC.13000No prior authorization
Prominence Healthfirst Of Texas13000No prior authorization
Atrio Health Plans121200Prior authorization required
Upmc Health Network, INC.1212012Prior authorization required
HMO Louisiana, INC.12000No prior authorization
Mount Carmel Health Plan, INC.110110No prior authorization
Pacificsource Community Health Plans110110No prior authorization
Community Insurance Company10000No prior authorization
Health Insurance Plan Of Greater New York10000No prior authorization
HMO Colorado, INC.10000No prior authorization
Quartz Health Plan Corporation10000No prior authorization
Compcare Health Services Insurance Corporation10000No prior authorization
Sanford Health Plan9000No prior authorization
Allina Health And Aetna Insurance Company9900Prior authorization required
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9900Prior authorization required
New York Quality Healthcare Corporation9000No prior authorization
Wellpoint Tennessee, INC.9000No prior authorization
Healthier New Jersey Insurance Company8000No prior authorization
Meridian Health Plan Of Michigan, INC.8000No prior authorization
Healthpartners, INC.8800Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8000No prior authorization
Mvp Health Plan, INC.8080No prior authorization
Keystone Health Plan East, INC.8000No prior authorization
Network Health Insurance Corporation8800Prior authorization required
Prominence Healthfirst8000No prior authorization
Fallon Community Health Plan8000No prior authorization
Peak Health Insurance Corporation8808Prior authorization required
Health Partners Plans, INC.8000No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care8000No prior authorization
Viva Health, INC.7070No prior authorization
Martin'S Point Generations Advantage, INC.7070No prior authorization
Wellpoint Health Plans, INC.7000No prior authorization
Astiva Health, INC.7700Prior authorization required
Bravo Health Mid-Atlantic, INC.7000No prior authorization
Health Alliance Plan Of Michigan7700Prior authorization required
Medica Insurance Company7000No prior authorization
Summacare INC.7700Prior authorization required
Keystone Health Plan Central, INC.7000No prior authorization
Champion Health Plan Of California INC7700Prior authorization required
Essence Healthcare PPO, INC.7000No prior authorization
Champion Health Plan Of Nevada, INC.7700Prior authorization required
Bluecross And Blueshield Of South Carolina7000No prior authorization
Providence Health Assurance7000No prior authorization
Alterwood Advantage, INC.7700Prior authorization required
Mass General Brigham Health Plan, INC6000No prior authorization
Buckeye Community Health Plan, INC.6000No prior authorization
Christus Health Plan6060No prior authorization
Nebraska Total Care, INC.6000No prior authorization
Gold Kidney Of Florida INC6600Prior authorization required
Essence Healthcare, INC.6000No prior authorization
Hometown Health Plan, INC.6000No prior authorization
Presbyterian Health Plan6600Prior authorization required
Elderplan, INC.6060No prior authorization
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6060No prior authorization
Globalhealth, INC.6600Prior authorization required
Preferred Care Network, INC.6000No prior authorization
Scott And White Health Plan6000No prior authorization
Coordinated Care Of Washington, INC.5000No prior authorization
Chinese Community Health Plan5500Prior authorization required
Hopkins Health Advantage, INC.5050No prior authorization
Alliance Health And Life Insurance Company5500Prior authorization required
Sapphire Edge, INC.5000No prior authorization
Independent Health Association, INC.5000No prior authorization
Coordinated Care Corporation5000No prior authorization
Oh Chs Snp INC.5500Prior authorization required
Usable Mutual Insurance Company5050No prior authorization
Gold Kidney Of Arizona5500Prior authorization required
Meridian Health Plan Of Illinois, INC.5000No prior authorization
Sunflower State Health Plan, INC.5000No prior authorization
Prominence Healthfirst Of Florida INC5000No prior authorization
Priority Health Choice, INC.5500Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5000No prior authorization
Hpmp Of Florida, INC.5050No prior authorization
Home State Health Plan, INC.4000No prior authorization
Baylor Scott & White Insurance Company4000No prior authorization
Care N' Care Insurance Company Of North Carolina4000No prior authorization
Health New England, INC.4000No prior authorization
Pennsylvania Health & Wellness, INC.4000No prior authorization
The Health Plan Of West Virginia, INC.4000No prior authorization
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4040No prior authorization
Qcc Insurance Company4000No prior authorization
Leon Health, INC.4000No prior authorization
Verda Health Plan Of Texas INC4400Prior authorization required
Security Health Plan Of Wisconsin, INC.4000No prior authorization
Sharp Health Plan4040No prior authorization
Gateway Health Plan, INC.4000No prior authorization
Capital Health Plan4000No prior authorization
Boston Medical Center Health Plan, INC.4000No prior authorization
Bluecross Blueshield Kansas Solutions, INC.4000No prior authorization
Clever Care Of Golden State, INC.4040No prior authorization
Central Mass Health, LLC4000No prior authorization
Ghs Insurance Company4000No prior authorization
Thp Insurance Company4000No prior authorization
Aspire Health Plan4000No prior authorization
Amh Health, LLC4000No prior authorization
Dean Health Plan, INC.4404Prior authorization required
Quartz Health Plan Mn Corporation4000No prior authorization
Medisun, INC.3000No prior authorization
Metroplus Health Plan, INC.3030No prior authorization
Wellpoint West Virginia , INC.3000No prior authorization
Louisiana Health Service & Indemnity Company3000No prior authorization
Eternalhealth, INC.3000No prior authorization
Patrius Health, INC.3000No prior authorization
Marquis Advantage, INC.3303Prior authorization required
Partners Insurance Company INC3000No prior authorization
Mount Carmel Health Insurance Company3030No prior authorization
Community Care Health Plan Of Louisiana, INC.3000No prior authorization
Village Senior Services Corporation3300Prior authorization required
Trillium Community Health Plan, INC.3000No prior authorization
Senior Whole Health, LLC3030No prior authorization
Baycare Select Health Plans, INC.3300Prior authorization required
Cox Health Systems HMO INC3300Prior authorization required
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3000No prior authorization
Volunteer State Health Plan3003No prior authorization
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3000No prior authorization
Procare Advantage, LLC3303Prior authorization required
Eternalhealth Of Arizona INC3000No prior authorization
Paramount Care, INC.3030No prior authorization
Aultcare Health Insuring Corporation3000No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3030No prior authorization
Geisinger Indemnity Insurance Company3303Prior authorization required
Simpra Advantage, INC.3303Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3000No prior authorization
Provider Partners Health Plan Of North Carolina3000No prior authorization
Provider Partners Health Plan Of Indiana3000No prior authorization
Celtic Insurance Company3000No prior authorization
Amerihealth Insurance Company Of New Jersey3000No prior authorization
Vns Choice3300Prior authorization required
Mercy Care3030No prior authorization
Usable HMO, INC.3030No prior authorization
Mclaren Health Plan, INC.3300Prior authorization required
Liberty Advantage, LLC3303Prior authorization required
Southeastern Indiana Health Organization, INC.3300Prior authorization required
Managed Health Services Insurance CORP.3000No prior authorization
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3000No prior authorization
Hamaspik, INC.2000No prior authorization
Arizona Physicians Ipa, INC.2000No prior authorization
Ks Plan Administrators, LLC2000No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Beshp, INC.2000No prior authorization
Wellpoint Iowa, INC.2000No prior authorization
Commonwealth Care Alliance, INC.2020No prior authorization
Arkansas Superior Select, INC.2200Prior authorization required
Wellpoint Washington, INC.2000No prior authorization
Neighborhood Health Plan Of Rhode Island2020No prior authorization
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2202Prior authorization required
Signature Advantage, LLC2200Prior authorization required
Primewest Rural Mn Health Care Access Initiative2200Prior authorization required
Sentara Health Plans2202Prior authorization required
Verda Health Plan Of Arizona, INC.2200Prior authorization required
Partners Insurance Company Of New Jersey INC2000No prior authorization
Sanford Health Plan Of Minnesota2000No prior authorization
Nhc Advantage, LLC2202Prior authorization required
American Health Plan Of Ut, INC.2202Prior authorization required
Upmc For You, INC2202Prior authorization required
American Health Plan Of Missouri, INC.2202Prior authorization required
Selectcare Of Texas, INC.2000No prior authorization
New Century Health Plan, INC.2200Prior authorization required
Community Health Group2200Prior authorization required
Banner - University Care Advantage2000No prior authorization
Texas Independence Health Plan, INC.2200Prior authorization required
Tufts Health Public Plans, INC.2000No prior authorization
Imperial Health Plan Of California, INC.2200Prior authorization required
Bridgeway Health Solutions Of Arizona, INC.2000No prior authorization
Denver Health Medical Plan, INC.2200Prior authorization required
Community Health Plan Of Washington2000No prior authorization
Senior Whole Health Of New York, INC.2020No prior authorization
Nextblue Of North Dakota Insurance Company2200Prior authorization required
Healthpartners Insurance Company2200Prior authorization required
Missouri Care, Incorporated2000No prior authorization
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
Elite Health Plan, INC.2200Prior authorization required
American Health Plan Of Iowa INC2202Prior authorization required
Elderserve Health, INC.2000No prior authorization
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2202Prior authorization required
Memorial Hermann Health Plan2000No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2000No prior authorization
Excellus Health Plan Community Care LLC2000No prior authorization
Group Health Cooperative Of Eau Claire2000No prior authorization
Georgia Assurance, INC.2202Prior authorization required
Caresource Georgia CO.2000No prior authorization
Visiting Nurse Association Of Central New York2200Prior authorization required
Trinity Health Plan Of Michigan INC2020No prior authorization
Wyoblue Advantage INC2200Prior authorization required
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2020No prior authorization
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2000No prior authorization
Hm Health Insurance Company2000No prior authorization
Horizon Insurance Company2000No prior authorization
Longevity Health Plan Of Colorado, INC.1000No prior authorization
Tsg Guard, INC.1100Prior authorization required
Local Initiative Health Authority For La County1101Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.1010No prior authorization
Longevity Health Plan Of Florida, INC.1000No prior authorization
Imperial County Local Health Authority1100Prior authorization required
Community Care Health Plan, INC.1000No prior authorization
Independent Care Health Plan1000No prior authorization
Itasca Medical Care1010No prior authorization
HMO Minnesota1000No prior authorization
Wellpoint South Carolina, INC.1000No prior authorization
Upper Peninsula Health Plan, LLC1000No prior authorization
Connecticare Insurance Company, INC.1010No prior authorization
Independent Health Benefits Corporation1000No prior authorization
Oklahoma Superior Select, INC.1101Prior authorization required
Provider Partners Health Plan Of Illinois1000No prior authorization
Allcare Health Plan, INC.1100Prior authorization required
Samaritan Health Plans, INC.1000No prior authorization
Ghs Health Maintenance Organization, INC.1000No prior authorization
Santa Clara County Health Authority1100Prior authorization required
Provider Partners Health Plan Of Texas, INC.1000No prior authorization
Kern Health Systems1100Prior authorization required
Hap Caresource1000No prior authorization
Paramount Insurance Company1010No prior authorization
Absolute Total Care, INC.1000No prior authorization
Longevity Health Plan Of North Carolina, INC.1000No prior authorization
Orange County Health Authority1100Prior authorization required
Health Choice Arizona, INC.1010No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1100Prior authorization required
San Joaquin County Health Commission1100Prior authorization required
Banner Health Plan, INC.1000No prior authorization
Aids Healthcare Foundation1100Prior authorization required
Health Plan Of Careoregon, INC.1000No prior authorization
Alohacare1000No prior authorization
San Mateo Health Commission1101Prior authorization required
Caresource Ohio, INC.1000No prior authorization
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1101Prior authorization required
Upmc Health Coverage, INC.1101Prior authorization required
Provider Partners Health Plan Of Kentucky1000No prior authorization
Longevity Health Plan Of Michigan, INC.1000No prior authorization
Santa Barbara San Luis Obispo Regional Health Authority Dba1100Prior authorization required
American Health Plan, INC.1101Prior authorization required
San Francisco Health Authority Dba San Francisco Health Plan1100Prior authorization required
Horizon Healthcare Of New Jersey, INC.1000No prior authorization
Longevity Health Plan Of New York, INC.1000No prior authorization
Hawaii Medical Service Association (Hmsa)1010No prior authorization
Dignity Care Corporation1101Prior authorization required
Inland Empire Health Plan1100Prior authorization required
West Virginia Senior Advantage, INC.1100Prior authorization required
Longevity Health Plan Of Illinois, INC.1000No prior authorization
Ventura County Medi-Cal Managed Care Commission1000No prior authorization
Healthfirst Insurance Company, INC.1010No prior authorization
American Health Plan Of Indiana INC1101Prior authorization required
American Health Plan Of Ms, INC.1101Prior authorization required
American Health Plan Of Pennsylvania INC1101Prior authorization required

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