Benefily
Varies by plan

Does Health Care Service Corporation require prior authorization for Skyrizi?

Prior authorization for Skyrizi differs across Health Care Service Corporation's Medicare Part D plans and product strengths — 3 of 4 Skyrizi 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.

  • 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 ML risankizumab-rzaa 150 MG/ML Auto-Injector [Skyrizi]254069531 / 3131031Prior authorization required
1 ML risankizumab-rzaa 150 MG/ML Prefilled Syringe [Skyrizi]254069931 / 3131031Prior authorization required
2.4 ML risankizumab-rzaa 150 MG/ML Cartridge [Skyrizi]260462831 / 3131031Prior authorization required
1.2 ML risankizumab-rzaa 150 MG/ML Cartridge [Skyrizi]26137590 / 31000Not on formulary

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

Plan-by-plan detail — 1 ML risankizumab-rzaa 150 MG/ML Auto-Injector [Skyrizi]

Skyrizi has 4 products in the corpus; this table is for 1 ML risankizumab-rzaa 150 MG/ML Auto-Injector [Skyrizi], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP)H8634-0091YesNoYes
Blue Cross Medicare Advantage Balance (PPO)H8634-0315YesNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0015YesNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0025YesNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0125YesNoYes
Blue Cross Medicare Advantage Basic Plus (HMO-POS)H3822-0075YesNoYes
Blue Cross Medicare Advantage Choice Plus (PPO)H0107-0055YesNoYes
Blue Cross Medicare Advantage Choice Plus (PPO)H8634-0035YesNoYes
Blue Cross Medicare Advantage Choice Premier (PPO)H8634-0045YesNoYes
Blue Cross Medicare Advantage Classic (PPO)H0107-0035YesNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0085YesNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0105YesNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0225YesNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0275YesNoYes
Blue Cross Medicare Advantage Complete (PPO)H8634-0235YesNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H0107-0075YesNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0215YesNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0245YesNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0295YesNoYes
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H3251-0291YesNoYes
Blue Cross Medicare Advantage Essential (PPO)H8634-0125YesNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H0107-0105YesNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0185YesNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0255YesNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0305YesNoYes
Blue Cross Medicare Advantage Optimum (PPO)H0107-0045YesNoYes
Blue Cross Medicare Advantage Optimum (PPO)H8634-0325YesNoYes
Blue Cross Medicare Advantage Preferred (PPO)H8634-0335YesNoYes
Blue Cross Medicare Advantage Premier Plus (HMO-POS)H3822-0085YesNoYes
Blue Cross Medicare Advantage Select (HMO)H3251-0025YesNoYes
Blue Cross Medicare Advantage Value (HMO)H3822-0145YesNoYes
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.

Skyrizi at other payers

Or see Skyrizi 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.