Benefily
No prior authorization

Does Atrio Health Plans require prior authorization for Isentress?

Atrio Health Plans does not require prior authorization for Isentress 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 productPlans coveringRequire prior authStep therapyQty limitStatus
raltegravir 100 MG Chewable Tablet [Isentress]123559112 / 12000No prior authorization
raltegravir 25 MG Chewable Tablet [Isentress]123559512 / 12000No prior authorization
raltegravir 100 MG Granules for Oral Suspension [Isentress]148684112 / 12000No prior authorization
raltegravir 600 MG Oral Tablet [Isentress]19243150 / 12000Not on formulary
raltegravir 400 MG Oral Tablet [Isentress]7448460 / 12000Not on formulary

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

Plan-by-plan detail — raltegravir 100 MG Chewable Tablet [Isentress]

Isentress has 5 products in the corpus; this table is for raltegravir 100 MG Chewable Tablet [Isentress], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
ATRIO Choice Rx (PPO)H6743-0015NoNoNo
ATRIO Choice Rx (PPO)H6743-0075NoNoNo
ATRIO Choice Rx (PPO)H6743-0255NoNoNo
ATRIO Choice Rx (PPO)H7006-0075NoNoNo
ATRIO Choice Rx (PPO)H7006-0185NoNoNo
ATRIO Prime Rx (HMO)H5995-0045NoNoNo
ATRIO Prime Rx (PPO)H6743-0265NoNoNo
ATRIO Prime Rx (PPO)H6743-0285NoNoNo
ATRIO Prime Rx (PPO)H6743-0305NoNoNo
ATRIO Special Needs Plan (HMO D-SNP)H3814-0071NoNoNo
ATRIO Special Needs Plan (HMO D-SNP)H3814-0301NoNoNo
ATRIO Support Rx (PPO C-SNP)H7006-0225NoNoNo
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.

Isentress at other payers

Or see Isentress 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.