Does Florida Blue Medicare, INC. require prior authorization for Caplyta?
Prior authorization for Caplyta differs across Florida Blue Medicare, INC.'s Medicare Part D plans and product strengths — 3 of 3 Caplyta products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.
Some plans require authorization and others do not. The member's specific plan decides.
- Prior authorization requirements differ across this payer's plans: 2 of 15 covering plans require it. Check the specific plan the member is enrolled in — the plan name and contract number are on their insurance card.
By product strength
| RxNorm product | Plans covering | Require prior auth | Status |
|---|---|---|---|
| lumateperone 42 MG Oral Capsule [Caplyta]2275613 | 15 / 15 | 2 | Varies by plan |
| lumateperone 10.5 MG Oral Capsule [Caplyta]2607531 | 15 / 15 | 2 | Varies by plan |
| lumateperone 21 MG Oral Capsule [Caplyta]2607535 | 15 / 15 | 2 | Varies by plan |
Product names come from RxNorm (U.S. National Library of Medicine).
- 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.
Caplyta at other payers
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.