No prior authorization
Does Blue Cross Blue Shield (affiliate) require prior authorization for Aristada?
Blue Cross Blue Shield (affiliate) does not require prior authorization for Aristada on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]1673274 | 123 / 269 | 0 | 0 | 123 | No prior authorization |
| 2.4 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]1673278 | 123 / 269 | 0 | 0 | 123 | No prior authorization |
| 3.2 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]1673280 | 123 / 269 | 0 | 0 | 123 | No prior authorization |
| 3.9 ML aripiprazole lauroxil 273 MG/ML Prefilled Syringe [Aristada]1925264 | 123 / 269 | 0 | 0 | 123 | No prior authorization |
| 2.4 ML aripiprazole lauroxil 281.3 MG/ML Prefilled Syringe [Aristada]2049343 | 123 / 269 | 0 | 0 | 107 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]
Aristada has 5 products in the corpus; this table is for 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Anthem Dual Advantage (HMO D-SNP) | H5422-018 | 5 | No | No | Yes |
| Anthem Extra Help (HMO-POS) | H5422-013 | 5 | No | No | Yes |
| Anthem Full Dual Advantage (HMO D-SNP) | H5422-019 | 5 | No | No | Yes |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-010 | 5 | No | No | Yes |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-010 | 5 | No | No | Yes |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-011 | 5 | No | No | Yes |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) | H0544-004 | 5 | No | No | Yes |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) | H0544-010 | 5 | No | No | Yes |
| Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP) | H4161-014 | 5 | No | No | Yes |
| Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP) | H4161-015 | 5 | No | No | Yes |
| Anthem I CareMore Home Care (HMO I-SNP) | H0544-005 | 5 | No | No | Yes |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) | H0544-015 | 5 | No | No | Yes |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) | H0544-020 | 5 | No | No | Yes |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) | H0544-014 | 5 | No | No | Yes |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) | H0544-019 | 5 | No | No | Yes |
| Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) | H4161-016 | 5 | No | No | Yes |
| Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) | H4161-017 | 5 | No | No | Yes |
| Anthem I CareMore Medicare Advantage (HMO-POS) | H4161-011 | 5 | No | No | Yes |
| Anthem I CareMore Medicare Advantage (HMO-POS) | H4161-013 | 5 | No | No | Yes |
| Anthem I CareMore Medicare Advantage 2 (HMO-POS) | H0544-002 | 5 | No | No | Yes |
| Anthem I CareMore Premium Savings (HMO-POS) | H4161-012 | 5 | No | No | Yes |
| Anthem Kidney Care (HMO-POS C-SNP) | H5422-015 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-056 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-061 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-062 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-063 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-064 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-065 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-095 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-096 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H0544-108 | 5 | No | No | Yes |
| Anthem Medicare Advantage (HMO-POS) | H5422-011 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-002 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-003 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-004 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-005 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-006 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-007 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-009 | 5 | No | No | Yes |
| Anthem Prime (HMO-POS) | H4161-010 | 5 | No | No | Yes |
| Anthem Select (HMO-POS) | H0544-058 | 5 | No | No | Yes |
| Anthem Select (HMO-POS) | H0544-066 | 5 | No | No | Yes |
| Anthem Select (HMO-POS) | H0544-069 | 5 | No | No | Yes |
| Anthem Select (HMO-POS) | H0544-091 | 5 | No | No | Yes |
| Anthem Select (HMO-POS) | H0544-098 | 5 | No | No | Yes |
| Blue Advantage Complete (PPO) | H0104-012 | 5 | No | No | Yes |
| Blue Advantage Complete (PPO) | H0104-014 | 5 | No | No | Yes |
| Blue Advantage Premier (PPO) | H0104-015 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-009 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-014 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-014 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-010 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-010 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-011 | 5 | No | No | Yes |
| Blue Cross Medicare Advantage Secure (HMO) | H8547-001 | 5 | No | No | Yes |
| Blue Medicare Advantage Classic PPO (PPO) | H5900-008 | 5 | No | No | Yes |
| Blue Medicare Advantage Enhanced PPO (PPO) | H5900-004 | 5 | No | No | Yes |
| Blue Medicare Advantage PPO (PPO) | H5900-001 | 5 | No | No | Yes |
| Blue Medicare Choice (HMO) | H3449-026 | 5 | No | No | Yes |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 5 | No | No | Yes |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 5 | No | No | Yes |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 5 | No | No | Yes |
| Blue Medicare Essential (HMO) | H3449-027 | 5 | No | No | Yes |
| Blue Medicare Essential (HMO) | H3449-027 | 5 | No | No | Yes |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 5 | No | No | Yes |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 5 | No | No | Yes |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 5 | No | No | Yes |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 5 | No | No | Yes |
| Blue Medicare PPO Enhanced (PPO) | H3404-003 | 5 | No | No | Yes |
| Blue Medicare PPO Enhanced (PPO) | H3404-003 | 5 | No | No | Yes |
| Blue Medicare Rx Enhanced (PDP) | S5540-004 | 5 | No | No | Yes |
| Blue MedicareRx Essentials (PDP) | S5726-020 | 5 | No | No | Yes |
| Blue MedicareRx Plus (PDP) | S5726-014 | 5 | No | No | Yes |
| BlueMedicare Complete Rx (PDP) | S5904-002 | 5 | No | No | Yes |
| BlueRx Enhanced Plus (PDP) | S1030-001 | 5 | No | No | Yes |
| CareFirst BlueCross BlueShield Advantage Complete (PPO) | H7379-002 | 5 | No | No | Yes |
| CareFirst BlueCross BlueShield Advantage DualPrime (HMO D-SNP) | H8854-002 | 5 | No | No | Yes |
| CareFirst BlueCross BlueShield Advantage Essential (PPO) | H7379-001 | 5 | No | No | Yes |
| Experience Health Medicare Advantage (HMO) | H3777-002 | 5 | No | No | Yes |
| Freedom Blue PPO Classic (PPO) | H3916-001 | 5 | No | No | Yes |
| Freedom Blue PPO Classic (PPO) | H3916-002 | 5 | No | No | Yes |
| Freedom Blue PPO Deluxe (PPO) | H3916-005 | 5 | No | No | Yes |
| Freedom Blue PPO Select (PPO) | H3916-022 | 5 | No | No | Yes |
| Freedom Blue PPO Select (PPO) | H3916-024 | 5 | No | No | Yes |
| Freedom Blue PPO Standard (PPO) | H3916-015 | 5 | No | No | Yes |
| Healthy Blue + Medicare (HMO-POS D-SNP) | H9147-001 | 5 | No | No | Yes |
| Medicare HMO Blue FlexRx (HMO-POS) | H2261-023 | 5 | No | No | Yes |
| Medicare HMO Blue FlexRx (HMO-POS) | H2261-023 | 5 | No | No | Yes |
| Medicare HMO Blue PlusRx (HMO) | H2261-005 | 5 | No | No | Yes |
| Medicare HMO Blue SaverRx (HMO-POS) | H2261-024 | 5 | No | No | Yes |
| Medicare HMO Blue ValueRx (HMO) | H2261-022 | 5 | No | No | Yes |
| Medicare HMO Blue ValueRx (HMO) | H2261-022 | 5 | No | No | Yes |
| Medicare PPO Blue EssentialRx (PPO) | H2230-019 | 5 | No | No | Yes |
| Medicare PPO Blue PlusRx (PPO) | H2230-002 | 5 | No | No | Yes |
| Medicare PPO Blue ValueRx (PPO) | H2230-018 | 5 | No | No | Yes |
| Medicare PPO Blue ValueRx (PPO) | H2230-018 | 5 | No | No | Yes |
| Platinum Blue Choice Plan with Rx (Cost) | H2461-009 | 5 | No | No | Yes |
| Platinum Blue Complete Plan with Rx (Cost) | H2461-010 | 5 | No | No | Yes |
| Regence BlueAdvantage HMO (HMO) | H1997-013 | 5 | No | No | Yes |
| Regence BlueAdvantage HMO (HMO) | H6237-009 | 5 | No | No | Yes |
Showing 100 of 123 covering plans.
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.
Aristada 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.