Payer Coverage Intelligence
Know Your Coverage
Before You Need It
Compare insurance coverage requirements across 20 plans for 56 medications. Real policy data, updated from payer sources.
Trending Medications
Coverage Requirements Overview
Compare what each plan requires for coverage approval. Tap any cell to see the full policy.
| Medication | Aetna Health Plans | Aetna Medicare | Anthem California | Anthem Georgia | Anthem New York | BCBS Illinois | BCBS Michigan Commercial | BCBS Texas | Blue Cross NC Commercial | Blue Shield of California Commercial | Cigna Commercial | Cigna Medicare Advantage | Florida Blue | Humana Commercial | Humana Medicare Advantage | Medicare - CMS | Medicare - Novitas Solutions | UHC Commercial | UHC Exchange | UHC Medicare Advantage |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mounjaro | 8 | — | — | — | — | — | — | — | — | — | 6 | 7 | — | — | 6 | — | 3 | 5 | — | — |
| Ozempic | 9 | — | — | — | — | — | — | — | — | — | 5 | 5 | — | — | 5 | — | 3 | 5 | — | — |
| Wegovy | 7 | — | — | — | — | — | — | — | — | — | 4 | 5 | — | — | — | — | — | 7 | — | — |
| Actemra | 9 | 8 | 8 | 7 | 4 | 3 | 8 | — | 10 | 9 | 6 | 7 | 9 | 9 | 8 | — | — | 7 | 5 | 7 |
| Advair Diskus | 4 | — | — | — | — | — | — | — | — | — | 10 | 6 | — | — | — | — | — | 7 | — | 4 |
| Aimovig | 7 | 4 | 5 | — | 5 | — | — | — | — | — | 4 | 4 | 9 | 4 | — | — | — | 6 | — | 7 |
| Ajovy | — | — | — | — | 5 | 5 | — | — | — | — | 5 | 5 | — | 5 | 5 | — | 3 | 8 | — | 8 |
| Amerge | 6 | — | — | — | — | — | — | — | — | — | 7 | 6 | — | — | — | — | — | 6 | — | — |
| Axert | — | — | — | — | — | — | — | — | — | — | 4 | — | — | — | 5 | — | — | 6 | — | — |
| Bivigam | — | 6 | — | — | — | 4 | 9 | — | — | — | — | 7 | — | 6 | 9 | — | — | 9 | — | 5 |
| Botox | 4 | 9 | — | — | 7 | — | 10 | — | — | — | 8 | 10 | 6 | 4 | 6 | — | — | 6 | — | 8 |
| Cimzia | 6 | 5 | 10 | 7 | 8 | 4 | 3 | 5 | 9 | 7 | 8 | 7 | 6 | 7 | 8 | — | — | 9 | — | — |
| Cinqair | 6 | 8 | — | — | — | — | 8 | — | — | — | 4 | 9 | — | 5 | 7 | — | — | 8 | — | 5 |
| Cosentyx | 7 | 5 | 7 | 7 | 8 | 7 | 7 | 5 | 8 | — | 8 | 6 | — | 7 | 8 | — | 3 | 9 | — | 4 |
| Dulera | 4 | — | — | — | — | — | — | — | — | — | 6 | 6 | — | — | — | — | — | 7 | — | — |
Requirements: 1-3 Fewer 4-5 Some 6-7 Multiple 8-10 Extensive
Browse by Condition
All Medications
Browse by Insurer
Fighting a denial? We can help.
Appealio handles the full appeal process from evidence gathering to insurer submission. Free to start.
Need help with a denial?