Benefily
Varies by plan

Does Blue Cross Blue Shield (affiliate) require prior authorization for Zurzuvae?

Prior authorization for Zurzuvae differs across Blue Cross Blue Shield (affiliate)'s Medicare Part D plans and product strengths — 3 of 3 Zurzuvae products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

  • Prior authorization requirements differ across this payer's plans: 195 of 269 covering plans require it. Check the specific plan the member is enrolled in — the plan name and contract number are on their insurance card.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
zuranolone 20 MG Oral Capsule [Zurzuvae]2669916269 / 2691950218Varies by plan
zuranolone 25 MG Oral Capsule [Zurzuvae]2669920269 / 2691950218Varies by plan
zuranolone 30 MG Oral Capsule [Zurzuvae]2669924269 / 2691950218Varies by plan

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

Plan-by-plan detail — zuranolone 20 MG Oral Capsule [Zurzuvae]

Zurzuvae has 3 products in the corpus; this table is for zuranolone 20 MG Oral Capsule [Zurzuvae], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Dual Advantage (HMO D-SNP)H5422-0185YesNoNo
Anthem Extra Help (HMO-POS)H5422-0135YesNoNo
Anthem Full Dual Advantage (HMO D-SNP)H5422-0195YesNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0105YesNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0105YesNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0115YesNoNo
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0045YesNoNo
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0105YesNoNo
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0145YesNoNo
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0155YesNoNo
Anthem I CareMore Home Care (HMO I-SNP)H0544-0055YesNoNo
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0155YesNoNo
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0205YesNoNo
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0145YesNoNo
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0195YesNoNo
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0165YesNoNo
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0175YesNoNo
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0115YesNoNo
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0135YesNoNo
Anthem I CareMore Medicare Advantage 2 (HMO-POS)H0544-0025YesNoNo
Anthem I CareMore Premium Savings (HMO-POS)H4161-0125YesNoNo
Anthem Kidney Care (HMO-POS C-SNP)H5422-0155YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0565YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0615YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0625YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0635YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0645YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0655YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0955YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0965YesNoNo
Anthem Medicare Advantage (HMO-POS)H0544-1085YesNoNo
Anthem Medicare Advantage (HMO-POS)H5422-0115YesNoNo
Anthem Prime (HMO-POS)H4161-0025YesNoNo
Anthem Prime (HMO-POS)H4161-0035YesNoNo
Anthem Prime (HMO-POS)H4161-0045YesNoNo
Anthem Prime (HMO-POS)H4161-0055YesNoNo
Anthem Prime (HMO-POS)H4161-0065YesNoNo
Anthem Prime (HMO-POS)H4161-0075YesNoNo
Anthem Prime (HMO-POS)H4161-0095YesNoNo
Anthem Prime (HMO-POS)H4161-0105YesNoNo
Anthem Select (HMO-POS)H0544-0585YesNoNo
Anthem Select (HMO-POS)H0544-0665YesNoNo
Anthem Select (HMO-POS)H0544-0695YesNoNo
Anthem Select (HMO-POS)H0544-0915YesNoNo
Anthem Select (HMO-POS)H0544-0985YesNoNo
Blue Advantage Choice (PPO)H0104-0165NoNoYes
Blue Advantage Complete (PPO)H0104-0125NoNoYes
Blue Advantage Complete (PPO)H0104-0145NoNoYes
Blue Advantage Premier (PPO)H0104-0155NoNoYes
Blue Cross Medicare Advantage Choice (PPO)H5959-0095NoNoYes
Blue Cross Medicare Advantage Choice (PPO)H5959-0145NoNoYes
Blue Cross Medicare Advantage Choice (PPO)H5959-0145NoNoYes
Blue Cross Medicare Advantage Comfort (PPO)H5959-0155NoNoYes
Blue Cross Medicare Advantage Comfort (PPO)H5959-0165NoNoYes
Blue Cross Medicare Advantage Complete (PPO)H5959-0105NoNoYes
Blue Cross Medicare Advantage Complete (PPO)H5959-0105NoNoYes
Blue Cross Medicare Advantage Complete (PPO)H5959-0115NoNoYes
Blue Cross Medicare Advantage Core (PPO)H5959-0125NoNoYes
Blue Cross Medicare Advantage Core (PPO)H5959-0135NoNoYes
Blue Cross Medicare Advantage Core (PPO)H5959-0135NoNoYes
Blue Cross Medicare Advantage Secure (HMO)H8547-0015NoNoYes
Blue Medicare Advantage Classic PPO (PPO)H5900-0085YesNoYes
Blue Medicare Advantage Enhanced PPO (PPO)H5900-0045YesNoYes
Blue Medicare Advantage PPO (PPO)H5900-0015YesNoYes
Blue Medicare Choice (HMO)H3449-0265NoNoYes
Blue Medicare Enhanced (HMO-POS)H3449-0245NoNoYes
Blue Medicare Enhanced (HMO-POS)H3449-0245NoNoYes
Blue Medicare Enhanced (HMO-POS)H3449-0245NoNoYes
Blue Medicare Essential (HMO)H3449-0275NoNoYes
Blue Medicare Essential (HMO)H3449-0275NoNoYes
Blue Medicare Essential Plus (HMO-POS)H3449-0235NoNoYes
Blue Medicare Essential Plus (HMO-POS)H3449-0235NoNoYes
Blue Medicare Essential Plus (HMO-POS)H3449-0235NoNoYes
Blue Medicare Essential Plus (HMO-POS)H3449-0235NoNoYes
Blue Medicare PPO Enhanced (PPO)H3404-0035NoNoYes
Blue Medicare PPO Enhanced (PPO)H3404-0035NoNoYes
Blue Medicare Rx Enhanced (PDP)S5540-0045NoNoYes
Blue Medicare Rx Standard (PDP)S5540-0025NoNoYes
Blue MedicareRx Essentials (PDP)S5726-0205NoNoYes
Blue MedicareRx Plus (PDP)S5726-0145NoNoYes
Blue MedicareRx Value (PDP)S5726-0135NoNoYes
BlueCHiP for Medicare Access (HMO-POS)H4152-0225NoNoYes
BlueCHiP for Medicare Enhanced (HMO-POS)H4152-0135NoNoYes
BlueCHiP for Medicare Essential (HMO-POS)H4152-0235NoNoYes
BlueCHiP for Medicare Extra (HMO-POS)H4152-0185NoNoYes
BlueMedicare Complete Rx (PDP)S5904-0025NoNoYes
BlueMedicare Premier Rx (PDP)S5904-0015NoNoYes
BlueMedicare Select (PPO)H5434-0025NoNoYes
BlueMedicare Select (PPO)H5434-0455NoNoYes
BlueMedicare Value (PPO)H5434-0235NoNoYes
BlueMedicare Value (PPO)H5434-0245NoNoYes
BlueMedicare Value (PPO)H5434-0255NoNoYes
BlueMedicare Value (PPO)H5434-0265NoNoYes
BlueMedicare Value (PPO)H5434-0305NoNoYes
BlueMedicare Value (PPO)H5434-0315NoNoYes
BlueMedicare Value (PPO)H5434-0345NoNoYes
BlueMedicare Value (PPO)H5434-0355NoNoYes
BlueMedicare Value (PPO)H5434-0365NoNoYes
BlueRI for Duals (HMO D-SNP)H4152-0215NoNoYes
BlueRx Enhanced Plus (PDP)S1030-0015NoNoYes
Showing 100 of 269 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.

Zurzuvae at other payers

Or see Zurzuvae 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.