Abilify Maintena

Generic: aripiprazole im for

300MG, 400MG — Prefilled Syringe

Also known as: ABILIFY MAINTENA PRSY 300MG, 400MG; SRER 300MG, 400MG

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 31 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Basic Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 31 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 3 - High Cost Brand	—	—	—	None