Does Aetna (CVS Health) require prior authorization for Risperdal?
Aetna (CVS Health) does not require prior authorization for Risperdal on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
- This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| risperidone 1 MG Oral Tablet [Risperdal]104781 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 2 MG Oral Tablet [Risperdal]104782 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 3 MG Oral Tablet [Risperdal]104783 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 4 MG Oral Tablet [Risperdal]104784 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 1 MG/ML Oral Solution [Risperdal]211489 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 0.5 MG Oral Tablet [Risperdal]262222 | 0 / 658 | 0 | 0 | 0 | Not on formulary |
| risperidone 12.5 MG Injection [Risperdal]706825 | 10 / 658 | 0 | 0 | 10 | No prior authorization |
| risperidone 37.5 MG Injection [Risperdal]706827 | 10 / 658 | 0 | 0 | 10 | No prior authorization |
| risperidone 50 MG Injection [Risperdal]706829 | 10 / 658 | 0 | 0 | 10 | No prior authorization |
| risperidone 25 MG Injection [Risperdal]706831 | 10 / 658 | 0 | 0 | 10 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — risperidone 12.5 MG Injection [Risperdal]
Risperdal has 10 products in the corpus; this table is for risperidone 12.5 MG Injection [Risperdal], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Health First Classic H1099-001 (HMO-POS) | H1099-001 | 4 | No | No | Yes |
| Health First Complete Care H1099-023 (HMO) | H1099-023 | 4 | No | No | Yes |
| Health First Emerald Plus H1099-024 (HMO) | H1099-024 | 4 | No | No | Yes |
| Health First Emerald Plus H1099-026 (HMO) | H1099-026 | 4 | No | No | Yes |
| Health First Emerald Plus H1099-028 (HMO) | H1099-028 | 4 | No | No | Yes |
| Health First Premier Access H1099-025 (HMO-POS) | H1099-025 | 4 | No | No | Yes |
| Health First Premier Access H1099-027 (HMO-POS) | H1099-027 | 4 | No | No | Yes |
| Health First Rewards H1099-014 (HMO) | H1099-014 | 4 | No | No | Yes |
| Health First SunSaver H1099-016 (HMO) | H1099-016 | 4 | No | No | Yes |
| Health First Value H1099-006 (HMO) | H1099-006 | 4 | No | No | Yes |
- 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.
Risperdal at other payers
Or see Risperdal across every payer at once.
- Humana
- Centene (WellCare)
- Kaiser Permanente
- Cariten Health Plan INC.
- Careplus Health Plans, INC.
- Sunshine State Health Plan, INC.
- Triple S Advantage, INC.
- Harmony Health Plan, INC.
- Superior Healthplan, INC.
- New York Quality Healthcare Corporation
- Meridian Health Plan Of Michigan, INC.
- American Progressive Life & Hlth Ins Company Of Ny
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.