Benefily
Prior authorization required

Does Aetna (CVS Health) require prior authorization for Cosentyx?

Aetna (CVS Health) requires prior authorization for Cosentyx on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML secukinumab 150 MG/ML Prefilled Syringe [Cosentyx]159979715 / 6581505Prior authorization required
1 ML secukinumab 150 MG/ML Auto-Injector [Cosentyx]165324315 / 6581505Prior authorization required
0.5 ML secukinumab 150 MG/ML Prefilled Syringe [Cosentyx]255071315 / 6581505Prior authorization required
2 ML secukinumab 150 MG/ML Auto-Injector [Cosentyx]26373485 / 658505Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 1 ML secukinumab 150 MG/ML Prefilled Syringe [Cosentyx]

Cosentyx has 4 products in the corpus; this table is for 1 ML secukinumab 150 MG/ML Prefilled Syringe [Cosentyx], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Community First Medicare Advantage Alamo Plan (HMO)H5447-0015YesNoYes
Community First Medicare Advantage D-SNP (HMO D-SNP)H5447-0025YesNoYes
El Paso Health Giveback (HMO)H3407-0035YesNoYes
El Paso Health Medicare Advantage Dual (HMO D-SNP)H3407-0015YesNoYes
El Paso Health Total (HMO)H3407-0025YesNoYes
Health First Classic H1099-001 (HMO-POS)H1099-0015YesNoNo
Health First Complete Care H1099-023 (HMO)H1099-0235YesNoNo
Health First Emerald Plus H1099-024 (HMO)H1099-0245YesNoNo
Health First Emerald Plus H1099-026 (HMO)H1099-0265YesNoNo
Health First Emerald Plus H1099-028 (HMO)H1099-0285YesNoNo
Health First Premier Access H1099-025 (HMO-POS)H1099-0255YesNoNo
Health First Premier Access H1099-027 (HMO-POS)H1099-0275YesNoNo
Health First Rewards H1099-014 (HMO)H1099-0145YesNoNo
Health First SunSaver H1099-016 (HMO)H1099-0165YesNoNo
Health First Value H1099-006 (HMO)H1099-0065YesNoNo
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.

Cosentyx at other payers

Or see Cosentyx across every payer at once.

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.