Benefily

Does Medicare Part D cover Vigadrone?

Vigadrone appears on the Medicare Part D formularies of 251 payers in the corpus, across 4,397 plans. 204 payers require prior authorization on every covering plan, 2 on some plans, and 45 on none.

Beyond prior authorization: 7 covering plans require step therapy (another drug tried first) and 3,771 apply a quantity limit, on at least one Vigadrone 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
Humana8178170817Prior authorization required
Aetna (CVS Health)6536530653Prior authorization required
Devoted Health4154150415Prior authorization required
Blue Cross Blue Shield (affiliate)2401660144Varies by plan
Centene (WellCare)1971970197Prior authorization required
Cigna1711710171Prior authorization required
Kaiser Permanente115000No prior authorization
SCAN Health Plan74000No prior authorization
Elevance Health (Anthem)6767067Prior authorization required
Alignment Healthcare670067No prior authorization
Medco Containment Life And Medco Containment Ny6060060Prior authorization required
Molina Healthcare5151051Prior authorization required
Simply Healthcare Plans, INC.5050050Prior authorization required
Cariten Health Plan INC.4444044Prior authorization required
Priority Health373700Prior authorization required
Careplus Health Plans, INC.3636036Prior authorization required
Bravo Health Pennsylvania, INC.3535035Prior authorization required
Zing Health Of Michigan, INC.3333033Prior authorization required
Health Care Service Corporation310031No prior authorization
Solis Health Plans, INC.240024No prior authorization
Sunshine State Health Plan, INC.2424024Prior authorization required
Freedom Health, INC.2424024Prior authorization required
Capital Advantage Insurance Company230023No prior authorization
Mcs Advantage, INC.2020020Prior authorization required
Harmony Health Plan, INC.1919019Prior authorization required
Hcsc Insurance Services Company180018No prior authorization
California Physicians' Service1717017Prior authorization required
Medica Health Plans171700Prior authorization required
Upmc Health Plan, INC.1717017Prior authorization required
Bluecross Blueshield Of Tennessee, INC.170017No prior authorization
Wellpoint Texas, INC.1616016Prior authorization required
Ultimate Health Plans, INC.161600Prior authorization required
Excellus Health Plan, INC.16000No prior authorization
Medical Mutual Of Ohio161600Prior authorization required
Superior Healthplan, INC.1515015Prior authorization required
Optimum Healthcare, INC.1515015Prior authorization required
Central Health Plan Of California, INC.1515015Prior authorization required
Selecthealth, INC.1414014Prior authorization required
Wellpoint Insurance Company1414014Prior authorization required
Florida Blue Medicare, INC.130013No prior authorization
Clover Health1313013Prior authorization required
Healthsun Health Plans, INC.1313013Prior authorization required
Prominence Healthfirst Of Texas1313013Prior authorization required
Atrio Health Plans1212012Prior authorization required
Upmc Health Network, INC.1212012Prior authorization required
HMO Louisiana, INC.121200Prior authorization required
Mount Carmel Health Plan, INC.1111011Prior authorization required
Pacificsource Community Health Plans111100Prior authorization required
Community Insurance Company1010010Prior authorization required
Health Insurance Plan Of Greater New York100010No prior authorization
HMO Colorado, INC.1010010Prior authorization required
Quartz Health Plan Corporation101000Prior authorization required
Compcare Health Services Insurance Corporation1010010Prior authorization required
Sanford Health Plan9900Prior authorization required
Allina Health And Aetna Insurance Company9909Prior authorization required
Geisinger Health Plan9900Prior authorization required
New York Quality Healthcare Corporation9909Prior authorization required
Wellpoint Tennessee, INC.9909Prior authorization required
Healthier New Jersey Insurance Company8008No prior authorization
Meridian Health Plan Of Michigan, INC.8808Prior authorization required
Healthpartners, INC.8800Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8808Prior authorization required
Mvp Health Plan, INC.8808Prior authorization required
Prominence Healthfirst8808Prior authorization required
Fallon Community Health Plan8800Prior authorization required
Health Partners Plans, INC.8808Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8008No prior authorization
Viva Health, INC.7707Prior authorization required
Martin'S Point Generations Advantage, INC.7707Prior authorization required
Wellpoint Health Plans, INC.7707Prior authorization required
Astiva Health, INC.7707Prior authorization required
Bravo Health Mid-Atlantic, INC.7707Prior authorization required
Health Alliance Plan Of Michigan7000No prior authorization
Medica Insurance Company7700Prior authorization required
Summacare INC.7707Prior authorization required
Keystone Health Plan Central, INC.7007No prior authorization
Champion Health Plan Of California INC7707Prior authorization required
Essence Healthcare PPO, INC.7700Prior authorization required
Champion Health Plan Of Nevada, INC.7707Prior authorization required
Bluecross And Blueshield Of South Carolina7700Prior authorization required
Providence Health Assurance7077No prior authorization
Alterwood Advantage, INC.7707Prior authorization required
Mass General Brigham Health Plan, INC6606Prior authorization required
Buckeye Community Health Plan, INC.6606Prior authorization required
Christus Health Plan6606Prior authorization required
Nebraska Total Care, INC.6606Prior authorization required
Gold Kidney Of Florida INC6606Prior authorization required
Essence Healthcare, INC.6600Prior authorization required
Hometown Health Plan, INC.6600Prior authorization required
Presbyterian Health Plan6000No prior authorization
Elderplan, INC.6606Prior authorization required
Connecticare, INC.6606Prior authorization required
Globalhealth, INC.6606Prior authorization required
Scott And White Health Plan6006No prior authorization
Coordinated Care Of Washington, INC.5505Prior authorization required
Chinese Community Health Plan5505Prior authorization required
Hopkins Health Advantage, INC.5505Prior authorization required
Alliance Health And Life Insurance Company5000No prior authorization
Sapphire Edge, INC.5005No prior authorization
Independent Health Association, INC.5000No prior authorization
Coordinated Care Corporation5505Prior authorization required
Oh Chs Snp INC.5202Varies by plan
Usable Mutual Insurance Company5505Prior authorization required
Gold Kidney Of Arizona5505Prior authorization required
Meridian Health Plan Of Illinois, INC.5505Prior authorization required
Sunflower State Health Plan, INC.5505Prior authorization required
Prominence Healthfirst Of Florida INC5505Prior authorization required
Priority Health Choice, INC.5500Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5505Prior authorization required
Hpmp Of Florida, INC.5505Prior authorization required
Home State Health Plan, INC.4404Prior authorization required
Baylor Scott & White Insurance Company4004No prior authorization
Care N' Care Insurance Company Of North Carolina4400Prior authorization required
Health New England, INC.4404Prior authorization required
Pennsylvania Health & Wellness, INC.4404Prior authorization required
The Health Plan Of West Virginia, INC.4400Prior authorization required
Hawaii Medical Service Association4404Prior authorization required
Leon Health, INC.4404Prior authorization required
Verda Health Plan Of Texas INC4404Prior authorization required
Security Health Plan Of Wisconsin, INC.4400Prior authorization required
Sharp Health Plan4404Prior authorization required
Gateway Health Plan, INC.4404Prior authorization required
Capital Health Plan4004No prior authorization
Boston Medical Center Health Plan, INC.4400Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4004No prior authorization
Clever Care Of Golden State, INC.4404Prior authorization required
Central Mass Health, LLC4004No prior authorization
Ghs Insurance Company4004No prior authorization
Thp Insurance Company4400Prior authorization required
Aspire Health Plan4404Prior authorization required
Amh Health, LLC4404Prior authorization required
Quartz Health Plan Mn Corporation4400Prior authorization required
Medisun, INC.3300Prior authorization required
Metroplus Health Plan, INC.3303Prior authorization required
Wellpoint West Virginia , INC.3303Prior authorization required
Louisiana Health Service & Indemnity Company3300Prior authorization required
Eternalhealth, INC.3300Prior authorization required
Patrius Health, INC.3003No prior authorization
Partners Insurance Company INC3303Prior authorization required
Mount Carmel Health Insurance Company3303Prior authorization required
Community Care Health Plan Of Louisiana, INC.3303Prior authorization required
Village Senior Services Corporation3303Prior authorization required
Trillium Community Health Plan, INC.3303Prior authorization required
Senior Whole Health, LLC3303Prior authorization required
Baycare Select Health Plans, INC.3303Prior authorization required
Cox Health Systems HMO INC3303Prior authorization required
Wellpoint New Jersey, INC.3303Prior authorization required
Volunteer State Health Plan3003No prior authorization
Capital District Physicians' Health Plan, INC.3000No prior authorization
Eternalhealth Of Arizona INC3300Prior authorization required
Paramount Care, INC.3303Prior authorization required
Aultcare Health Insuring Corporation3000No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3303Prior authorization required
Geisinger Indemnity Insurance Company3300Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3300Prior authorization required
Provider Partners Health Plan Of North Carolina3300Prior authorization required
Provider Partners Health Plan Of Indiana3300Prior authorization required
Celtic Insurance Company3303Prior authorization required
Vns Choice3303Prior authorization required
Mercy Care3303Prior authorization required
Usable HMO, INC.3303Prior authorization required
Mclaren Health Plan, INC.3303Prior authorization required
Southeastern Indiana Health Organization, INC.3303Prior authorization required
Managed Health Services Insurance CORP.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3300Prior authorization required
Hamaspik, INC.2002No prior authorization
Ks Plan Administrators, LLC2200Prior authorization required
Beshp, INC.2200Prior authorization required
Wellpoint Iowa, INC.2202Prior authorization required
Commonwealth Care Alliance, INC.2202Prior authorization required
Arkansas Superior Select, INC.2000No prior authorization
Wellpoint Washington, INC.2202Prior authorization required
Neighborhood Health Plan Of Rhode Island2202Prior authorization required
Signature Advantage, LLC2000No prior authorization
Primewest Rural Mn Health Care Access Initiative2202Prior authorization required
Sentara Health Plans2202Prior authorization required
Verda Health Plan Of Arizona, INC.2202Prior authorization required
Partners Insurance Company Of New Jersey INC2202Prior authorization required
Sanford Health Plan Of Minnesota2200Prior authorization required
Upmc For You, INC2202Prior authorization required
Selectcare Of Texas, INC.2202Prior authorization required
New Century Health Plan, INC.2202Prior authorization required
Community Health Group2202Prior authorization required
Banner - University Care Advantage2200Prior authorization required
Texas Independence Health Plan, INC.2000No prior authorization
Imperial Health Plan Of California, INC.2202Prior authorization required
Bridgeway Health Solutions Of Arizona, INC.2202Prior authorization required
Denver Health Medical Plan, INC.2202Prior authorization required
Community Health Plan Of Washington2200Prior authorization required
Senior Whole Health Of New York, INC.2202Prior authorization required
Healthpartners Insurance Company2200Prior authorization required
Missouri Care, Incorporated2202Prior authorization required
Elite Health Plan, INC.2202Prior authorization required
Elderserve Health, INC.2200Prior authorization required
Memorial Hermann Health Plan2002No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2200Prior authorization required
Excellus Health Plan Community Care LLC2000No prior authorization
Group Health Cooperative Of Eau Claire2200Prior authorization required
Caresource Georgia CO.2200Prior authorization required
Visiting Nurse Association Of Central New York2202Prior authorization required
Trinity Health Plan Of Michigan INC2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2200Prior authorization required
Hm Health Insurance Company2200Prior authorization required
Horizon Insurance Company2002No prior authorization
Longevity Health Plan Of Colorado, INC.1100Prior authorization required
Tsg Guard, INC.1000No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.1101Prior authorization required
Longevity Health Plan Of Florida, INC.1100Prior authorization required
Imperial County Local Health Authority1101Prior authorization required
Independent Care Health Plan1101Prior authorization required
Itasca Medical Care1101Prior authorization required
HMO Minnesota1001No prior authorization
Wellpoint South Carolina, INC.1101Prior authorization required
Upper Peninsula Health Plan, LLC1100Prior authorization required
Connecticare Insurance Company, INC.1101Prior authorization required
Independent Health Benefits Corporation1000No prior authorization
Provider Partners Health Plan Of Illinois1100Prior authorization required
Allcare Health Plan, INC.1101Prior authorization required
Samaritan Health Plans, INC.1100Prior authorization required
Ghs Health Maintenance Organization, INC.1001No prior authorization
Santa Clara County Health Authority1101Prior authorization required
Provider Partners Health Plan Of Texas, INC.1100Prior authorization required
Kern Health Systems1101Prior authorization required
Hap Caresource1100Prior authorization required
Paramount Insurance Company1101Prior authorization required
Absolute Total Care, INC.1101Prior authorization required
Longevity Health Plan Of North Carolina, INC.1100Prior authorization required
Orange County Health Authority1000No prior authorization
Health Choice Arizona, INC.1101Prior authorization required
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1101Prior authorization required
San Joaquin County Health Commission1101Prior authorization required
Banner Health Plan, INC.1100Prior authorization required
Aids Healthcare Foundation1101Prior authorization required
Alohacare1100Prior authorization required
San Mateo Health Commission1101Prior authorization required
Caresource Ohio, INC.1100Prior authorization required
Upmc Health Coverage, INC.1101Prior authorization required
Provider Partners Health Plan Of Kentucky1100Prior authorization required
Longevity Health Plan Of Michigan, INC.1100Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba1101Prior authorization required
San Francisco Health Authority Dba San Francisco Health Plan1101Prior authorization required
Horizon Healthcare Of New Jersey, INC.1001No prior authorization
Longevity Health Plan Of New York, INC.1100Prior authorization required
Hawaii Medical Service Association (Hmsa)1101Prior authorization required
Healthy Mississippi, INC.1101Prior authorization required
Inland Empire Health Plan1101Prior authorization required
West Virginia Senior Advantage, INC.1000No prior authorization
Longevity Health Plan Of Illinois, INC.1100Prior authorization required
Ventura County Medi-Cal Managed Care Commission1001No prior authorization
Healthfirst Insurance Company, INC.1101Prior authorization required

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