Does Humana require prior authorization for Risperdal?
Humana does not require prior authorization for Risperdal 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| risperidone 1 MG Oral Tablet [Risperdal]104781 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 2 MG Oral Tablet [Risperdal]104782 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 3 MG Oral Tablet [Risperdal]104783 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 4 MG Oral Tablet [Risperdal]104784 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 1 MG/ML Oral Solution [Risperdal]211489 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 0.5 MG Oral Tablet [Risperdal]262222 | 0 / 817 | 0 | 0 | 0 | Not on formulary |
| risperidone 12.5 MG Injection [Risperdal]706825 | 817 / 817 | 0 | 0 | 817 | No prior authorization |
| risperidone 37.5 MG Injection [Risperdal]706827 | 817 / 817 | 0 | 0 | 817 | No prior authorization |
| risperidone 50 MG Injection [Risperdal]706829 | 817 / 817 | 0 | 0 | 817 | No prior authorization |
| risperidone 25 MG Injection [Risperdal]706831 | 817 / 817 | 0 | 0 | 817 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — risperidone 12.5 MG Injection [Risperdal]
Risperdal has 10 products in the corpus; this table is for risperidone 12.5 MG Injection [Risperdal], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | S5884-101 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-102 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-103 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-104 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-105 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-106 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-107 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-108 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-109 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-110 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-111 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-112 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-113 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-114 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-115 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-116 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-131 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-132 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-133 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-134 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-135 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-136 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-137 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-138 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-139 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-140 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-141 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-142 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-143 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-144 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-145 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-146 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-147 | 4 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-216 | 4 | No | No | Yes |
| Humana Cleveland Clinic Preferred (HMO-POS) | H6622-023 | 4 | No | No | Yes |
| Humana Community (HMO-POS) | H4623-002 | 4 | No | No | Yes |
| Humana Community (HMO) | H0292-001 | 4 | No | No | Yes |
| Humana Community (HMO) | H1036-236 | 4 | No | No | Yes |
| Humana Community (HMO) | H1036-332 | 4 | No | No | Yes |
| Humana Community (HMO) | H5178-002 | 4 | No | No | Yes |
| Humana Community (HMO) | H5619-159 | 4 | No | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1036-234 | 4 | No | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1468-017 | 4 | No | No | Yes |
| Humana Community HMO SNP-DE (HMO D-SNP) | H1036-235 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-406 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-424 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-431 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-452 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5970-031 | 4 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H7617-112 | 4 | No | No | Yes |
| Humana Direct Choice GIveback (PPO) | H5970-032 | 4 | No | No | Yes |
| Humana Dual Fully Integrated (HMO D-SNP) | H4329-001 | 4 | No | No | Yes |
| Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) | H2875-001 | 4 | No | No | Yes |
| Humana Dual Fully Integrated H2875-003 (HMO D-SNP) | H2875-003 | 4 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H0963-001 | 4 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-339 | 4 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-340 | 4 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-341 | 4 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1396-001 | 4 | No | No | Yes |
| Humana Dual Select H0028-078 (HMO D-SNP) | H0028-078 | 4 | No | No | Yes |
| Humana Dual Select H0028-079 (HMO D-SNP) | H0028-079 | 4 | No | No | Yes |
| Humana Dual Select H1036-307 (HMO D-SNP) | H1036-307 | 4 | No | No | Yes |
| Humana Dual Select H1036-329 (HMO D-SNP) | H1036-329 | 4 | No | No | Yes |
| Humana Dual Select H1951-056 (HMO D-SNP) | H1951-056 | 4 | No | No | Yes |
| Humana Dual Select H2875-005 (HMO D-SNP) | H2875-005 | 4 | No | No | Yes |
| Humana Dual Select H2875-006 (HMO-POS D-SNP) | H2875-006 | 4 | No | No | Yes |
| Humana Dual Select H4939-002 (HMO-POS D-SNP) | H4939-002 | 4 | No | No | Yes |
| Humana Dual Select H5216-206 (PPO D-SNP) | H5216-206 | 4 | No | No | Yes |
| Humana Dual Select H5216-298 (PPO D-SNP) | H5216-298 | 4 | No | No | Yes |
| Humana Dual Select H5216-361 (PPO D-SNP) | H5216-361 | 4 | No | No | Yes |
| Humana Dual Select H5216-385 (PPO D-SNP) | H5216-385 | 4 | No | No | Yes |
| Humana Dual Select H5525-046 (PPO D-SNP) | H5525-046 | 4 | No | No | Yes |
| Humana Dual Select H5525-072 (PPO D-SNP) | H5525-072 | 4 | No | No | Yes |
| Humana Dual Select H5619-075 (HMO D-SNP) | H5619-075 | 4 | No | No | Yes |
| Humana Dual Select H5619-093 (HMO D-SNP) | H5619-093 | 4 | No | No | Yes |
| Humana Dual Select H5619-126 (HMO-POS D-SNP) | H5619-126 | 4 | No | No | Yes |
| Humana Dual Select H5619-165 (HMO D-SNP) | H5619-165 | 4 | No | No | Yes |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | H6622-027 | 4 | No | No | Yes |
| Humana Dual Select H7617-039 (PPO D-SNP) | H7617-039 | 4 | No | No | Yes |
| Humana Dual Select H7617-074 (PPO D-SNP) | H7617-074 | 4 | No | No | Yes |
| Humana Dual Select H7617-083 (PPO D-SNP) | H7617-083 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H0028-063 (HMO) | H0028-063 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H1036-271 (HMO) | H1036-271 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-308 (PPO) | H5216-308 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-358 (PPO) | H5216-358 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-405 (PPO) | H5216-405 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-429 (PPO) | H5216-429 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-430 (PPO) | H5216-430 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-017 (PPO) | H7617-017 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-024 (PPO) | H7617-024 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-035 (PPO) | H7617-035 | 4 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-100 (PPO) | H7617-100 | 4 | No | No | Yes |
| Humana FMOL Baton Rouge H1951-053 (HMO) | H1951-053 | 4 | No | No | Yes |
| Humana Full Access Giveback H5216-306 (PPO) | H5216-306 | 4 | No | No | Yes |
| Humana Full Access Giveback H5216-311 (PPO) | H5216-311 | 4 | No | No | Yes |
| Humana Full Access Giveback H5216-393 (PPO) | H5216-393 | 4 | No | No | Yes |
| Humana Full Access Giveback H7617-058 (PPO) | H7617-058 | 4 | No | No | Yes |
- 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.
Risperdal at other payers
Or see Risperdal across every payer at once.
- Centene (WellCare)
- Kaiser Permanente
- Cariten Health Plan INC.
- Careplus Health Plans, INC.
- Sunshine State Health Plan, INC.
- Triple S Advantage, INC.
- Harmony Health Plan, INC.
- Superior Healthplan, INC.
- Aetna (CVS Health)
- New York Quality Healthcare Corporation
- Meridian Health Plan Of Michigan, INC.
- American Progressive Life & Hlth Ins Company Of Ny
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.