Benefily
Sign inCreate account

Does Medicare Part D cover Xcopri?

Xcopri appears on the Medicare Part D formularies of 200 payers in the corpus. 85 require prior authorization on every covering plan, 3 on some plans, and 112 on none.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

PayerPlans coveringRequire prior authStatus
UnitedHealthcare731731Prior authorization required
Aetna (CVS Health)6475Varies by plan
Devoted Health4150No prior authorization
Blue Cross Blue Shield (affiliate)237147Varies by plan
Cigna171171Prior authorization required
Centene (WellCare)1450No prior authorization
Elevance Health (Anthem)6765Varies by plan
Alignment Healthcare670No prior authorization
Medco Containment Life And Medco Containment Ny6060Prior authorization required
Molina Healthcare510No prior authorization
Simply Healthcare Plans, INC.5050Prior authorization required
Uhc Of California4040Prior authorization required
Bravo Health Pennsylvania, INC.3535Prior authorization required
Preferred Care Partners, INC.3535Prior authorization required
Zing Health Of Michigan, INC.330No prior authorization
Health Care Service Corporation310No prior authorization
Solis Health Plans, INC.240No prior authorization
Freedom Health, INC.2424Prior authorization required
Capital Advantage Insurance Company230No prior authorization
Physicians Health Choice Of Texas, LLC2222Prior authorization required
Mcs Advantage, INC.2020Prior authorization required
Hcsc Insurance Services Company180No prior authorization
California Physicians' Service1717Prior authorization required
Bluecross Blueshield Of Tennessee, INC.170No prior authorization
Wellpoint Texas, INC.1616Prior authorization required
Excellus Health Plan, INC.160No prior authorization
Medical Mutual Of Ohio160No prior authorization
Sunshine State Health Plan, INC.150No prior authorization
Optimum Healthcare, INC.1515Prior authorization required
Central Health Plan Of California, INC.150No prior authorization
Selecthealth, INC.140No prior authorization
Wellpoint Insurance Company1414Prior authorization required
Peoples Health, INC.1313Prior authorization required
Clover Health130No prior authorization
Healthsun Health Plans, INC.1313Prior authorization required
HMO Louisiana, INC.120No prior authorization
Mount Carmel Health Plan, INC.110No prior authorization
Harmony Health Plan, INC.100No prior authorization
Community Insurance Company1010Prior authorization required
Health Insurance Plan Of Greater New York100No prior authorization
HMO Colorado, INC.1010Prior authorization required
Compcare Health Services Insurance Corporation1010Prior authorization required
Sanford Health Plan99Prior authorization required
Allina Health And Aetna Insurance Company90No prior authorization
Geisinger Health Plan99Prior authorization required
Doctors Healthcare Plans, INC.99Prior authorization required
Wellpoint Tennessee, INC.99Prior authorization required
Healthier New Jersey Insurance Company80No prior authorization
Healthpartners, INC.80No prior authorization
Mvp Health Plan, INC.80No prior authorization
Keystone Health Plan East, INC.80No prior authorization
Network Health Insurance Corporation88Prior authorization required
Fallon Community Health Plan80No prior authorization
Peak Health Insurance Corporation88Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care80No prior authorization
Viva Health, INC.70No prior authorization
Martin'S Point Generations Advantage, INC.70No prior authorization
Wellpoint Health Plans, INC.77Prior authorization required
Bravo Health Mid-Atlantic, INC.77Prior authorization required
Health Alliance Plan Of Michigan77Prior authorization required
Keystone Health Plan Central, INC.70No prior authorization
Essence Healthcare PPO, INC.70No prior authorization
Bluecross And Blueshield Of South Carolina77Prior authorization required
Providence Health Assurance70No prior authorization
Christus Health Plan60No prior authorization
Essence Healthcare, INC.60No prior authorization
Hometown Health Plan, INC.66Prior authorization required
Elderplan, INC.60No prior authorization
Perennial Advantage Of Colorado, INC.66Prior authorization required
Connecticare, INC.60No prior authorization
Preferred Care Network, INC.66Prior authorization required
Scott And White Health Plan60No prior authorization
Hopkins Health Advantage, INC.50No prior authorization
Alliance Health And Life Insurance Company55Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny50No prior authorization
Sapphire Edge, INC.50No prior authorization
Usable Mutual Insurance Company50No prior authorization
Hpmp Of Florida, INC.50No prior authorization
Baylor Scott & White Insurance Company40No prior authorization
Health New England, INC.44Prior authorization required
The Health Plan Of West Virginia, INC.40No prior authorization
Communitycare Government Programs, INC.44Prior authorization required
Hawaii Medical Service Association40No prior authorization
Qcc Insurance Company40No prior authorization
Security Health Plan Of Wisconsin, INC.44Prior authorization required
Superior Healthplan, INC.40No prior authorization
Sharp Health Plan40No prior authorization
Meridian Health Plan Of Illinois, INC.40No prior authorization
Capital Health Plan40No prior authorization
Boston Medical Center Health Plan, INC.40No prior authorization
Bluecross Blueshield Kansas Solutions, INC.40No prior authorization
Clever Care Of Golden State, INC.40No prior authorization
Ghs Insurance Company40No prior authorization
Thp Insurance Company40No prior authorization
Amh Health, LLC44Prior authorization required
Dean Health Plan, INC.44Prior authorization required
Medisun, INC.33Prior authorization required
Metroplus Health Plan, INC.30No prior authorization
Wellpoint West Virginia , INC.33Prior authorization required
Nebraska Total Care, INC.30No prior authorization
Louisiana Health Service & Indemnity Company30No prior authorization
Eternalhealth, INC.33Prior authorization required
Patrius Health, INC.30No prior authorization
Marquis Advantage, INC.33Prior authorization required
Mount Carmel Health Insurance Company30No prior authorization
Community Care Health Plan Of Louisiana, INC.33Prior authorization required
Meridian Health Plan Of Michigan, INC.30No prior authorization
Senior Whole Health, LLC30No prior authorization
Secur INC33Prior authorization required
Wellpoint New Jersey, INC.33Prior authorization required
Volunteer State Health Plan30No prior authorization
Align Senior Care California INC.33Prior authorization required
Pruitthealth Premier, INC.33Prior authorization required
Procare Advantage, LLC33Prior authorization required
Coordinated Care Corporation30No prior authorization
Eternalhealth Of Arizona INC33Prior authorization required
Paramount Care, INC.30No prior authorization
Mount Carmel Health Plan Of Idaho, INC.30No prior authorization
Geisinger Indemnity Insurance Company33Prior authorization required
Simpra Advantage, INC.33Prior authorization required
Amerihealth Insurance Company Of New Jersey30No prior authorization
Mercy Care30No prior authorization
Usable HMO, INC.30No prior authorization
Liberty Advantage, LLC33Prior authorization required
Perennial Advantage Of Ohio, INC.33Prior authorization required
Coordinated Care Of Washington, INC.20No prior authorization
Hamaspik, INC.20No prior authorization
Arizona Physicians Ipa, INC.22Prior authorization required
Beshp, INC.22Prior authorization required
Wellpoint Iowa, INC.22Prior authorization required
Home State Health Plan, INC.20No prior authorization
Wellpoint Washington, INC.22Prior authorization required
Lifeworks Advantage, LLC22Prior authorization required
Kansas Superior Select, INC.22Prior authorization required
Sentara Health Plans22Prior authorization required
Sanford Health Plan Of Minnesota22Prior authorization required
American Health Plan Of Ut, INC.22Prior authorization required
American Health Plan Of Missouri, INC.22Prior authorization required
Selectcare Of Texas, INC.20No prior authorization
New York Quality Healthcare Corporation20No prior authorization
Community Health Plan Of Washington20No prior authorization
Senior Whole Health Of New York, INC.20No prior authorization
Healthpartners Insurance Company20No prior authorization
Missouri Care, Incorporated22Prior authorization required
Pruitthealth Premier North Carolina, LLC22Prior authorization required
Sunflower State Health Plan, INC.20No prior authorization
American Health Plan Of Iowa INC22Prior authorization required
Elderserve Health, INC.20No prior authorization
Align Senior Care Mi, LLC22Prior authorization required
Isnp Ventures, LLC22Prior authorization required
Memorial Hermann Health Plan20No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.22Prior authorization required
Excellus Health Plan Community Care LLC20No prior authorization
Georgia Assurance, INC.22Prior authorization required
Caresource Georgia CO.20No prior authorization
Trinity Health Plan Of Michigan INC20No prior authorization
Arkansas Health & Wellness Health Plan, INC.20No prior authorization
Community Health Choice Texas, INC.22Prior authorization required
Mount Carmel Health Plan Of New York, INC.20No prior authorization
Align Senior Care Florida, INC.22Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp20No prior authorization
Hm Health Insurance Company22Prior authorization required
Horizon Insurance Company20No prior authorization
Longevity Health Plan Of Colorado, INC.10No prior authorization
Buckeye Community Health Plan, INC.10No prior authorization
Local Initiative Health Authority For La County11Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.10No prior authorization
Longevity Health Plan Of Florida, INC.10No prior authorization
Itasca Medical Care10No prior authorization
HMO Minnesota10No prior authorization
Wellpoint South Carolina, INC.11Prior authorization required
Pennsylvania Health & Wellness, INC.10No prior authorization
Upper Peninsula Health Plan, LLC10No prior authorization
Connecticare Insurance Company, INC.10No prior authorization
Oklahoma Superior Select, INC.11Prior authorization required
Ghs Health Maintenance Organization, INC.10No prior authorization
Nhc Advantage, LLC11Prior authorization required
Hap Caresource10No prior authorization
Celtic Insurance Company10No prior authorization
Paramount Insurance Company10No prior authorization
Longevity Health Plan Of North Carolina, INC.10No prior authorization
Health Choice Arizona, INC.10No prior authorization
San Mateo Health Commission11Prior authorization required
Caresource Ohio, INC.10No prior authorization
Lagniappe Advantage Insurance Company11Prior authorization required
American Health Plan Of Fl, INC.11Prior authorization required
Longevity Health Plan Of Michigan, INC.10No prior authorization
Group Health Cooperative Of Eau Claire10No prior authorization
American Health Plan, INC.11Prior authorization required
Managed Health Services Insurance CORP.10No prior authorization
Horizon Healthcare Of New Jersey, INC.10No prior authorization
Longevity Health Plan Of New York, INC.10No prior authorization
Hawaii Medical Service Association (Hmsa)10No prior authorization
Dignity Care Corporation11Prior authorization required
Longevity Health Plan Of Illinois, INC.10No prior authorization
Ventura County Medi-Cal Managed Care Commission10No prior authorization
Healthfirst Insurance Company, INC.10No prior authorization
American Health Plan Of Indiana INC11Prior authorization required
American Health Plan Of Ms, INC.11Prior authorization required
American Health Plan Of Pennsylvania INC11Prior authorization required

“Require prior auth” counts a plan when any Xcopri product on its formulary needs authorization.

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.

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.