Prior authorization required

Does Arkansas Superior Select, INC. require prior authorization for Qulipta?

Arkansas Superior Select, INC. requires prior authorization for Qulipta 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
atogepant 10 MG Oral Tablet [Qulipta]2571842	2 / 2	2	2	Prior authorization required
atogepant 30 MG Oral Tablet [Qulipta]2571846	2 / 2	2	2	Prior authorization required
atogepant 60 MG Oral Tablet [Qulipta]2571850	2 / 2	2	2	Prior authorization required

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

Plan-by-plan detail — atogepant 10 MG Oral Tablet [Qulipta]

Qulipta has 3 products in the corpus; this table is for atogepant 10 MG Oral Tablet [Qulipta], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP)	H1587-001	1	Yes	No	Yes
Tribute Select (HMO-POS I-SNP)	H1587-003	1	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.

Qulipta at other payers

Or see Qulipta 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.