Benefily
No prior authorization

Does Elevance Health (Anthem) require prior authorization for Pacerone?

Elevance Health (Anthem) does not require prior authorization for Pacerone 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 productPlans coveringRequire prior authStep therapyQty limitStatus
amiodarone hydrochloride 200 MG Oral Tablet [Pacerone]83434667 / 67000No prior authorization
amiodarone hydrochloride 400 MG Oral Tablet [Pacerone]83435067 / 67000No prior authorization
amiodarone hydrochloride 100 MG Oral Tablet [Pacerone]83595867 / 67000No prior authorization

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

Plan-by-plan detail — amiodarone hydrochloride 200 MG Oral Tablet [Pacerone]

Pacerone has 3 products in the corpus; this table is for amiodarone hydrochloride 200 MG Oral Tablet [Pacerone], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Chronic Care (HMO-POS C-SNP)H3447-0372NoNoNo
Anthem Chronic Care (HMO-POS C-SNP)H3447-0562NoNoNo
Anthem Dual Advantage (HMO D-SNP)H0629-0022NoNoNo
Anthem Dual Advantage (HMO D-SNP)H4694-0022NoNoNo
Anthem Dual Advantage (HMO D-SNP)H5854-0202NoNoNo
Anthem Dual Advantage (PPO D-SNP)H2441-0012NoNoNo
Anthem Dual Advantage (PPO D-SNP)H2836-0072NoNoNo
Anthem Extra Help (HMO-POS)H3447-0242NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H0629-0012NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H3447-0182NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H4694-0042NoNoNo
Anthem Full Dual Advantage (PPO D-SNP)H2836-0062NoNoNo
Anthem Full Dual Advantage 2 (HMO D-SNP)H3447-0532NoNoNo
Anthem Full Dual Advantage 2 (HMO D-SNP)H4694-0012NoNoNo
Anthem Full Dual Advantage Select (HMO D-SNP)H5854-0132NoNoNo
Anthem Full Dual Advantage Support (HMO D-SNP)H4694-0032NoNoNo
Anthem HealthPlus Full Dual Advantage (HMO D-SNP)H8432-0422NoNoNo
Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP)H8432-0412NoNoNo
Anthem HealthPlus Full Dual Advantage LTSS 2 (HMO D-SNP)H6988-0042NoNoNo
Anthem I PathWays Dual Care Advantage (HMO D-SNP)H0629-0032NoNoNo
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP)H0629-0042NoNoNo
Anthem Kidney Care (HMO-POS C-SNP)H3447-0332NoNoNo
Anthem Kidney Care (HMO-POS C-SNP)H5854-0122NoNoNo
Anthem Kidney Care (PPO C-SNP)H8552-0282NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0132NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0382NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0382NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0422NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0422NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0422NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0422NoNoNo
Anthem Medicare Advantage (HMO-POS)H8432-0404NoNoNo
Anthem Medicare Advantage (HMO)H5854-0192NoNoNo
Anthem Medicare Advantage (HMO)H5854-0192NoNoNo
Anthem Medicare Advantage (HMO)H8432-0094NoNoNo
Anthem Medicare Advantage (HMO)H8432-0104NoNoNo
Anthem Medicare Advantage (HMO)H8432-0114NoNoNo
Anthem Medicare Advantage (PPO)H4036-0262NoNoNo
Anthem Medicare Advantage (PPO)H4036-0362NoNoNo
Anthem Medicare Advantage (PPO)H4909-0142NoNoNo
Anthem Medicare Advantage (Regional PPO)R5941-0142NoNoNo
Anthem Medicare Advantage (Regional PPO)R5941-0162NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H3447-0252NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0064NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0094NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0104NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H7220-0042NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H8432-0164NoNoNo
Anthem Medicare Advantage 2 (PPO)H1607-0152NoNoNo
Anthem Medicare Advantage 2 (PPO)H4036-0302NoNoNo
Anthem Medicare Advantage 2 (PPO)H4909-0262NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0494NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0504NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0514NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0524NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H6988-0074NoNoNo
Anthem Medicare Advantage 3 (HMO)H7220-0092NoNoNo
Anthem Medicare Advantage 3 (HMO)H7220-0092NoNoNo
Anthem Medicare Advantage 3 (PPO)H1607-0122NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0082NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0252NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0342NoNoNo
Anthem Medicare Advantage 4 (HMO-POS)H3447-0392NoNoNo
Anthem Medicare Advantage 4 (HMO)H7220-0102NoNoNo
Anthem Medicare Advantage 4 (PPO)H4036-0172NoNoNo
Blue MedicareRx Premier (PDP)S2893-0031NoNoNo
Blue MedicareRx Value Plus (PDP)S2893-0012NoNoNo
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.

Pacerone at other payers

Or see Pacerone 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.