RisperDAL Consta Intramuscular

12.5 MG — Suspension

Atypical Antipsychotic

Also known as: RisperDAL Consta Intramuscular Suspension Reconstituted ER
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 7 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 7 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H1036-137 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice Giveback H5216-017 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice H5216-211 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Full Access H5525-034 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice Giveback H5525-035 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Simple Open (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice H5525-050 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice H5525-070 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice H5525-083 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H6622-025 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Choice H8145-004 (PFFS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
HumanaChoice H5525-049 (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Simple (HMO-POS) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Giveback Open (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Dual Liberty Open (PPO D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Assist Open (PPO) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Dual Access (HMO-POS D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 4 - Non-Preferred — — ✓ 2 per 28 days QL
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