Benefily
No prior authorization

Does Ultimate Health Plans, INC. require prior authorization for Aristada?

Ultimate Health Plans, INC. does not require prior authorization for Aristada 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 productPlans coveringRequire prior authStep therapyQty limitStatus
1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167327416 / 16000No prior authorization
2.4 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167327816 / 16000No prior authorization
3.2 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]167328016 / 16000No prior authorization
3.9 ML aripiprazole lauroxil 273 MG/ML Prefilled Syringe [Aristada]19252640 / 16000Not on formulary
2.4 ML aripiprazole lauroxil 281.3 MG/ML Prefilled Syringe [Aristada]20493430 / 16000Not on formulary

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

Plan-by-plan detail — 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada]

Aristada has 5 products in the corpus; this table is for 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Advantage Care by Ultimate (HMO C-SNP)H2962-0215NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0265NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0295NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0335NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0505NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0515NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0525NoNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0235NoNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0255NoNoNo
Advantage Plus by Ultimate (Full) (HMO D-SNP)H2962-0355NoNoNo
Advantage Plus by Ultimate (Partial) (HMO D-SNP)H2962-0365NoNoNo
Premier by Ultimate (HMO)H2962-0015NoNoNo
Premier by Ultimate (HMO)H2962-0285NoNoNo
Premier by Ultimate (HMO)H2962-0455NoNoNo
Premier by Ultimate (HMO)H2962-0465NoNoNo
Premier by Ultimate (HMO)H2962-0475NoNoNo
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.

Aristada at other payers

Or see Aristada 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.