Benefily
No prior authorization

Does Clover Health require prior authorization for Xcopri?

Clover Health does not require prior authorization for Xcopri 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
cenobamate 50 MG Oral Tablet [Xcopri]226570113 / 130013No prior authorization
cenobamate 100 MG Oral Tablet [Xcopri]228350513 / 130013No prior authorization
cenobamate 150 MG Oral Tablet [Xcopri]228350913 / 130013No prior authorization
cenobamate 200 MG Oral Tablet [Xcopri]22835130 / 13000Not on formulary
cenobamate 25 MG Oral Tablet [Xcopri]22835270 / 13000Not on formulary

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

Plan-by-plan detail — cenobamate 50 MG Oral Tablet [Xcopri]

Xcopri has 5 products in the corpus; this table is for cenobamate 50 MG Oral Tablet [Xcopri], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Clover Health Choice (PPO)H5141-0045NoNoYes
Clover Health Choice (PPO)H5141-0255NoNoYes
Clover Health Choice (PPO)H5141-0325NoNoYes
Clover Health Choice (PPO)H5141-0385NoNoYes
Clover Health Choice Giveback (PPO)H5141-0545NoNoYes
Clover Health Choice Value (PPO)H5141-0075NoNoYes
Clover Health Choice Value (PPO)H5141-0425NoNoYes
Clover Health Classic (HMO)H8010-0025NoNoYes
Clover Health LiveHealthy (PPO)H5141-0265NoNoYes
Clover Health LiveHealthy (PPO)H5141-0365NoNoYes
Clover Health LiveHealthy Giveback (PPO)H5141-0635NoNoYes
Clover Health LiveHealthy Value (PPO)H5141-0455NoNoYes
Clover Health Value (HMO)H8010-0035NoNoYes
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.

Xcopri at other payers

Or see Xcopri 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.