Benefily
No prior authorization

Does Excellus Health Plan, INC. require prior authorization for Aristada?

Excellus Health Plan, INC. does not require prior authorization for Aristada 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
1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167327416 / 16000No prior authorization
2.4 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167327816 / 16000No prior authorization
3.2 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167328016 / 16000No prior authorization
3.9 ML aripiprazole lauroxil 273 MG/ML Prefilled Syringe [Aristada]192526416 / 16000No prior authorization
2.4 ML aripiprazole lauroxil 281.3 MG/ML Prefilled Syringe [Aristada]20493430 / 16000Not on formulary

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

Plan-by-plan detail — 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]

Aristada has 5 products in the corpus; this table is for 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Medicare Blue Choice Core (HMO)H3351-0225NoNoNo
Medicare Blue Choice Optimum (HMO-POS)H3351-0065NoNoNo
Medicare Blue Choice Prime (HMO)H3351-0235NoNoNo
Medicare BlueActive (PPO)H3335-0555NoNoNo
Medicare BlueBalanced (PPO)H3335-0625NoNoNo
Medicare BlueClassic (PPO)H3335-0385NoNoNo
Medicare BlueEnhanced (PPO)H3335-0155NoNoNo
Medicare BlueEssential (PPO)H3335-0535NoNoNo
Medicare BluePlus (PPO)H3335-0185NoNoNo
Medicare BlueVital (PPO)H3335-0615NoNoNo
Univera SeniorChoice Advanced (HMO-POS)H3351-0195NoNoNo
Univera SeniorChoice Basic (HMO)H3351-0175NoNoNo
Univera SeniorChoice Core (PPO)H3335-0605NoNoNo
Univera SeniorChoice Extra (HMO)H3351-0205NoNoNo
Univera SeniorChoice Secure (HMO-POS)H3351-0025NoNoNo
Univera SeniorChoice Value Plus (HMO-POS)H3351-0125NoNoNo
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.

Aristada at other payers

Or see Aristada 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.