Erzofri extended-release injectable
Generic: paliperidone palmitate
Suspension
Injectable Antipsychotics — Injectable Long Acting
Also known as:
paliperidone palmitate
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
11 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Erzofri |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield of NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Invega Sustenna |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Invega Sustenna |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Invega Sustenna |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Invega Sustenna |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Invega Trinza |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Invega Trinza |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Invega Trinza |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Invega Trinza |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Erzofri |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Invega Trinza |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Erzofri |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Erzofri |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Erzofri |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Erzofri |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Invega Hafyera |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Invega Hafyera |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Invega Hafyera |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Invega Hafyera |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Invega Hafyera |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Invega Sustenna |
Tier 4 - Higher Cost Brand | — | — | — | None |
Medicare Part D
40 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Aetna Medicare Signature (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | ✓ | — | ✓ 1.5 per 28 days | PA | QL |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE 003 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE 005 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE 008 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED CHOICE 001 NC (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
Aetna Medicare Signature (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Dual (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Value Plus (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Prime (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature Care (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Enhanced (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Troy Medicare (HMO)
via Erzofri |
Tier 5 - Specialty | ✓ | — | ✓ 1.5 per 28 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | ✓ | — | ✓ 1.5 per 28 days | PA | QL |
|
DEVOTED CORE 001 NC (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED GIVEBACK 002 NC (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED GIVEBACK 012 NC (HMO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.5 per 28 days | QL |
|
Aetna Medicare Signature (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Enhanced (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Enhanced (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature Extra (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
|
Aetna Medicare Signature Giveback (PPO)
via Erzofri |
Tier 5 - Specialty | — | — | ✓ 1.50 per 28 days | QL |
NC Medicaid PDL
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC Medicaid Preferred Drug List 2026
via Invega Sustenna |
Preferred | — | — | — | None |
|
NC Medicaid Preferred Drug List 2026
via Invega Trinza |
Preferred | — | — | — | None |
| NC Medicaid Preferred Drug List 2026 | Preferred | — | — | — | None |