No prior authorization

Does Triple S Advantage, INC. require prior authorization for Erzofri?

Triple S Advantage, INC. does not require prior authorization for Erzofri 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 22 of 22 covering plans — the plan requires another drug be tried first.

By product strength

RxNorm product	Plans covering	Step therapy	Status
2.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699348	22 / 22	22	No prior authorization
0.75 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699350	22 / 22	22	No prior authorization
1 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699351	22 / 22	22	No prior authorization
1.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699352	22 / 22	22	No prior authorization
0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699353	22 / 22	22	No prior authorization
0.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]2699354	22 / 22	22	No prior authorization

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

Plan-by-plan detail — 2.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]

Erzofri has 6 products in the corpus; this table is for 2.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Ahorro Plus (HMO)	H5774-047	5	No	Yes	No
Ahorro Plus (HMO)	H5774-047	5	No	Yes	No
Ahorro Plus (HMO)	H5774-047	5	No	Yes	No
Ahorro Plus (HMO)	H5774-047	5	No	Yes	No
Ahorro Plus (HMO)	H5774-047	5	No	Yes	No
Brillante (HMO-POS)	H5774-031	5	No	Yes	No
Contigo Plus (HMO C-SNP)	H5774-022	5	No	Yes	No
ContigoEnMente (HMO C-SNP)	H5774-046	5	No	Yes	No
Enlace Plus (HMO)	H5774-038	5	No	Yes	No
PLATINO ADVANCE (HMO D-SNP)	H5774-041	1	No	Yes	No
PLATINO ADVANCE (HMO D-SNP)	H5774-041	1	No	Yes	No
PLATINO ADVANCE (HMO D-SNP)	H5774-041	1	No	Yes	No
PLATINO ADVANCE (HMO D-SNP)	H5774-041	1	No	Yes	No
PLATINO ADVANCE (HMO D-SNP)	H5774-041	1	No	Yes	No
Platino Blindao (HMO D-SNP)	H5774-028	1	No	Yes	No
Platino Enlace (HMO D-SNP)	H5774-035	1	No	Yes	No
PLATINO PLUS (HMO D-SNP)	H5774-043	1	No	Yes	No
PLATINO PLUS (HMO D-SNP)	H5774-043	1	No	Yes	No
PLATINO PLUS (HMO D-SNP)	H5774-043	1	No	Yes	No
PLATINO PLUS (HMO D-SNP)	H5774-043	1	No	Yes	No
PLATINO PLUS (HMO D-SNP)	H5774-043	1	No	Yes	No
�ptimo Plus (PPO)	H4005-004	5	No	Yes	No

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.

Erzofri at other payers

Or see Erzofri 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.