Prior authorization required

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

Aetna (CVS Health) requires prior authorization for Otezla 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 product	Plans covering	Require prior auth	Qty limit	Status
apremilast 20 MG Oral Tablet [Otezla]1492742	15 / 658	15	15	Prior authorization required
apremilast 30 MG Oral Tablet [Otezla]1492746	15 / 658	15	15	Prior authorization required
24 HR apremilast 75 MG Extended Release Oral Tablet [Otezla]2723452	15 / 658	15	15	Prior authorization required

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

Plan-by-plan detail — apremilast 20 MG Oral Tablet [Otezla]

Otezla has 3 products in the corpus; this table is for apremilast 20 MG Oral Tablet [Otezla], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Community First Medicare Advantage Alamo Plan (HMO)	H5447-001	5	Yes	No	Yes
Community First Medicare Advantage D-SNP (HMO D-SNP)	H5447-002	5	Yes	No	Yes
El Paso Health Giveback (HMO)	H3407-003	5	Yes	No	Yes
El Paso Health Medicare Advantage Dual (HMO D-SNP)	H3407-001	5	Yes	No	Yes
El Paso Health Total (HMO)	H3407-002	5	Yes	No	Yes
Health First Classic H1099-001 (HMO-POS)	H1099-001	5	Yes	No	Yes
Health First Complete Care H1099-023 (HMO)	H1099-023	5	Yes	No	Yes
Health First Emerald Plus H1099-024 (HMO)	H1099-024	5	Yes	No	Yes
Health First Emerald Plus H1099-026 (HMO)	H1099-026	5	Yes	No	Yes
Health First Emerald Plus H1099-028 (HMO)	H1099-028	5	Yes	No	Yes
Health First Premier Access H1099-025 (HMO-POS)	H1099-025	5	Yes	No	Yes
Health First Premier Access H1099-027 (HMO-POS)	H1099-027	5	Yes	No	Yes
Health First Rewards H1099-014 (HMO)	H1099-014	5	Yes	No	Yes
Health First SunSaver H1099-016 (HMO)	H1099-016	5	Yes	No	Yes
Health First Value H1099-006 (HMO)	H1099-006	5	Yes	No	Yes

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.

Otezla at other payers

Or see Otezla 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.