Benefily
No prior authorization

Does Superior Healthplan, INC. require prior authorization for Fanapt?

Superior Healthplan, INC. does not require prior authorization for Fanapt on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • No prior authorization is filed, but step therapy applies on 15 of 15 covering plans — the plan requires another drug be tried first.
  • 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
iloperidone 1 MG Oral Tablet [Fanapt]84872615 / 1501515No prior authorization
iloperidone 10 MG Oral Tablet [Fanapt]84873015 / 1501515No prior authorization
iloperidone 12 MG Oral Tablet [Fanapt]84873415 / 1501515No prior authorization
iloperidone 2 MG Oral Tablet [Fanapt]8487380 / 15000Not on formulary
iloperidone 4 MG Oral Tablet [Fanapt]8487420 / 15000Not on formulary
iloperidone 6 MG Oral Tablet [Fanapt]8487460 / 15000Not on formulary
iloperidone 8 MG Oral Tablet [Fanapt]8487500 / 15000Not on formulary

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

Plan-by-plan detail — iloperidone 1 MG Oral Tablet [Fanapt]

Fanapt has 7 products in the corpus; this table is for iloperidone 1 MG Oral Tablet [Fanapt], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare Assist (HMO)H5294-0135NoYesYes
Wellcare Assist (HMO)H5294-0165NoYesYes
Wellcare Dual Access (HMO D-SNP)H5294-0155NoYesYes
Wellcare Dual Liberty (HMO D-SNP)H5294-0105NoYesYes
Wellcare Dual Liberty Sync (HMO D-SNP)H5294-0215NoYesYes
Wellcare Dual Liberty Sync (HMO D-SNP)H5294-0225NoYesYes
Wellcare Dual Liberty Sync (HMO D-SNP)H5294-0235NoYesYes
Wellcare Dual Liberty Sync (HMO D-SNP)H5294-0245NoYesYes
Wellcare Dual Liberty Sync (HMO D-SNP)H5294-0255NoYesYes
Wellcare Giveback (HMO)H5294-0195NoYesYes
Wellcare Simple (HMO)H5294-0115NoYesYes
Wellcare Simple (HMO)H5294-0175NoYesYes
Wellcare Simple (HMO)H5294-0185NoYesYes
Wellcare Superior HealthPlan Dual Align (HMO D-SNP)H0062-0115NoYesYes
Wellcare Superior HealthPlan Dual Align (HMO D-SNP)H0062-0125NoYesYes
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.

Fanapt at other payers

Or see Fanapt 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.