Benefily
Prior authorization required

Does Clover Health require prior authorization for FYCOMPA?

Clover Health requires prior authorization for FYCOMPA 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 productPlans coveringRequire prior authStep therapyQty limitStatus
perampanel 2 MG Oral Tablet [FYCOMPA]135656313 / 1313013Prior authorization required
perampanel 4 MG Oral Tablet [FYCOMPA]135657213 / 1313013Prior authorization required
perampanel 6 MG Oral Tablet [FYCOMPA]135657613 / 1313013Prior authorization required
perampanel 8 MG Oral Tablet [FYCOMPA]135658013 / 1313013Prior authorization required
perampanel 10 MG Oral Tablet [FYCOMPA]135658413 / 1313013Prior authorization required
perampanel 12 MG Oral Tablet [FYCOMPA]135658813 / 1313013Prior authorization required
perampanel 0.5 MG/ML Oral Suspension [FYCOMPA]179012613 / 1313013Prior authorization required

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

Plan-by-plan detail — perampanel 2 MG Oral Tablet [FYCOMPA]

FYCOMPA has 7 products in the corpus; this table is for perampanel 2 MG Oral Tablet [FYCOMPA], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Clover Health Choice (PPO)H5141-0044YesNoYes
Clover Health Choice (PPO)H5141-0254YesNoYes
Clover Health Choice (PPO)H5141-0324YesNoYes
Clover Health Choice (PPO)H5141-0384YesNoYes
Clover Health Choice Giveback (PPO)H5141-0544YesNoYes
Clover Health Choice Value (PPO)H5141-0074YesNoYes
Clover Health Choice Value (PPO)H5141-0424YesNoYes
Clover Health Classic (HMO)H8010-0024YesNoYes
Clover Health LiveHealthy (PPO)H5141-0264YesNoYes
Clover Health LiveHealthy (PPO)H5141-0364YesNoYes
Clover Health LiveHealthy Giveback (PPO)H5141-0634YesNoYes
Clover Health LiveHealthy Value (PPO)H5141-0454YesNoYes
Clover Health Value (HMO)H8010-0034YesNoYes
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.

FYCOMPA at other payers

Or see FYCOMPA 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.