Does Allina Health And Aetna Insurance Company require prior authorization for Piqray 200 MG Daily Dose?
Allina Health And Aetna Insurance Company requires prior authorization for Piqray 200 MG Daily Dose 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 | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| {28 (alpelisib 200 MG Oral Tablet [Piqray]) } Pack [Piqray 200 MG Daily Dose]2169314 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — {28 (alpelisib 200 MG Oral Tablet [Piqray]) } Pack [Piqray 200 MG Daily Dose]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Allina Health Aetna Medicare Chronic (PPO C-SNP) | H3219-015 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Enhanced (PPO) | H3219-002 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Enhanced (PPO) | H3219-014 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Grand (PPO) | H3219-003 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Grand Extra (PPO) | H3219-004 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature (PPO) | H3219-001 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature (PPO) | H3219-012 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature Fit (PPO) | H3219-008 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Value (PPO C-SNP) | H3219-016 | 5 | Yes | 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.
Piqray 200 MG Daily Dose at other payers
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.