Long-Acting Agents Coverage in

Washington, DC

National Cabenuva Coverage

The information listed here is subject to change. Please confirm with your insurance provider for information regarding your specific group coverage and updates.

ADAP: Yes

For More Information Call (202) 671-4815

Medicaid: Yes

Prior authorization required.

Medicare: Some Coverage

Medicare (traditional, without Medicaid): 20% coinsurance
Medicare Advantage: Varies by plan (see medications list for “outpatient/Part B” drugs)
Part B: Covered, varies by plan (PA may or may not be required)
Part D: Varies by plan

Private / Commercial Coverage

Coverage information is intended to provide guidance in interpreting certain standard benefit plans administered by the companies listed below.

Private/Commercial insurance plans may provide coverage. Check the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] as they may differ significantly from the information below.

Aetna: Yes

Prior authorization required.

Learn More

Cigna: Yes
United Healthcare: Yes

Prior authorization required. (Apretude includes preventive care services coverage.)

Benefit coverage for health services is determined by the member-specific benefit plan document and applicable laws that may require coverage for a specific service.

Learn More

Kaiser: Yes

Prior authorization required. Only available on the following plans: Marketplace & Flexible Choice, 2TPOS OON Tier and Out-of-Area PPO (OOA-PPO) Formulary-Medical Benefit.

Blue Cross Blue Shield: Yes

Prior authorization required.

Benefit coverage for health services is determined by the member-specific benefit plan document and applicable laws that may require coverage for a specific service.

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