Benefily
Prior authorization required

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

Elevance Health (Anthem) requires prior authorization for Vigadrone 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
vigabatrin 500 MG Powder for Oral Solution [Vigadrone]204786867 / 6767067Prior authorization required
vigabatrin 500 MG Oral Tablet [Vigadrone]264235367 / 6767067Prior authorization required

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

Plan-by-plan detail — vigabatrin 500 MG Powder for Oral Solution [Vigadrone]

Vigadrone has 2 products in the corpus; this table is for vigabatrin 500 MG Powder for Oral Solution [Vigadrone], 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)H3447-0375YesNoYes
Anthem Chronic Care (HMO-POS C-SNP)H3447-0565YesNoYes
Anthem Dual Advantage (HMO D-SNP)H0629-0025YesNoYes
Anthem Dual Advantage (HMO D-SNP)H4694-0025YesNoYes
Anthem Dual Advantage (HMO D-SNP)H5854-0205YesNoYes
Anthem Dual Advantage (PPO D-SNP)H2441-0015YesNoYes
Anthem Dual Advantage (PPO D-SNP)H2836-0075YesNoYes
Anthem Extra Help (HMO-POS)H3447-0245YesNoYes
Anthem Full Dual Advantage (HMO D-SNP)H0629-0015YesNoYes
Anthem Full Dual Advantage (HMO D-SNP)H3447-0185YesNoYes
Anthem Full Dual Advantage (HMO D-SNP)H4694-0045YesNoYes
Anthem Full Dual Advantage (PPO D-SNP)H2836-0065YesNoYes
Anthem Full Dual Advantage 2 (HMO D-SNP)H3447-0535YesNoYes
Anthem Full Dual Advantage 2 (HMO D-SNP)H4694-0015YesNoYes
Anthem Full Dual Advantage Select (HMO D-SNP)H5854-0135YesNoYes
Anthem Full Dual Advantage Support (HMO D-SNP)H4694-0035YesNoYes
Anthem HealthPlus Full Dual Advantage (HMO D-SNP)H8432-0425YesNoYes
Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP)H8432-0415YesNoYes
Anthem HealthPlus Full Dual Advantage LTSS 2 (HMO D-SNP)H6988-0045YesNoYes
Anthem I PathWays Dual Care Advantage (HMO D-SNP)H0629-0035YesNoYes
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP)H0629-0045YesNoYes
Anthem Kidney Care (HMO-POS C-SNP)H3447-0335YesNoYes
Anthem Kidney Care (HMO-POS C-SNP)H5854-0125YesNoYes
Anthem Kidney Care (PPO C-SNP)H8552-0285YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0135YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0385YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0385YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0425YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0425YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0425YesNoYes
Anthem Medicare Advantage (HMO-POS)H3447-0425YesNoYes
Anthem Medicare Advantage (HMO-POS)H8432-0405YesNoYes
Anthem Medicare Advantage (HMO)H5854-0195YesNoYes
Anthem Medicare Advantage (HMO)H5854-0195YesNoYes
Anthem Medicare Advantage (HMO)H8432-0095YesNoYes
Anthem Medicare Advantage (HMO)H8432-0105YesNoYes
Anthem Medicare Advantage (HMO)H8432-0115YesNoYes
Anthem Medicare Advantage (PPO)H4036-0265YesNoYes
Anthem Medicare Advantage (PPO)H4036-0365YesNoYes
Anthem Medicare Advantage (PPO)H4909-0145YesNoYes
Anthem Medicare Advantage (Regional PPO)R5941-0145YesNoYes
Anthem Medicare Advantage (Regional PPO)R5941-0165YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H3447-0255YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H6988-0065YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H6988-0095YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H6988-0105YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H7220-0045YesNoYes
Anthem Medicare Advantage 2 (HMO-POS)H8432-0165YesNoYes
Anthem Medicare Advantage 2 (PPO)H1607-0155YesNoYes
Anthem Medicare Advantage 2 (PPO)H4036-0305YesNoYes
Anthem Medicare Advantage 2 (PPO)H4909-0265YesNoYes
Anthem Medicare Advantage 3 (HMO-POS)H3447-0495YesNoYes
Anthem Medicare Advantage 3 (HMO-POS)H3447-0505YesNoYes
Anthem Medicare Advantage 3 (HMO-POS)H3447-0515YesNoYes
Anthem Medicare Advantage 3 (HMO-POS)H3447-0525YesNoYes
Anthem Medicare Advantage 3 (HMO-POS)H6988-0075YesNoYes
Anthem Medicare Advantage 3 (HMO)H7220-0095YesNoYes
Anthem Medicare Advantage 3 (HMO)H7220-0095YesNoYes
Anthem Medicare Advantage 3 (PPO)H1607-0125YesNoYes
Anthem Medicare Advantage 3 (PPO)H4036-0085YesNoYes
Anthem Medicare Advantage 3 (PPO)H4036-0255YesNoYes
Anthem Medicare Advantage 3 (PPO)H4036-0345YesNoYes
Anthem Medicare Advantage 4 (HMO-POS)H3447-0395YesNoYes
Anthem Medicare Advantage 4 (HMO)H7220-0105YesNoYes
Anthem Medicare Advantage 4 (PPO)H4036-0175YesNoYes
Blue MedicareRx Premier (PDP)S2893-0035YesNoYes
Blue MedicareRx Value Plus (PDP)S2893-0015YesNoYes
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.

Vigadrone at other payers

Or see Vigadrone 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.