Does Blue Shield Advantage (HMO) cover paliperidone?
Blue Shield Advantage (HMO)
H0504-050-0 · MA_LOCAL · Medicare Part D
paliperidone
Do you get help with your Medicare drug costs?None of these
Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.
paliperidoneunder Blue Shield Advantage (HMO)
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
25%of the price your plan negotiates
Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. Part D caps what you pay out of pocket at $2,100 for 2026. Before that, you pay the full price until you have paid $340 this year.
This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.
Amount limit applies — how much depends on the strength you are prescribed — the cap for each one is listed below. You can still fill it; more than that needs your plan's approval, which your doctor's office requests.
- Tier
- Tier 4
- Approval first
- Required
- Try another first
- No
- Amount limit
- Varies by strength
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.
Covered forms and strengths (21)
- 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 4Approval first0.25 syringes per 28 days
- 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 4Approval first0.25 mL per 28 days
- 0.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 5Approval first0.5 syringes per 28 days
- 0.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 5Approval first0.5 mL per 28 days
- 0.75 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 5Approval first0.75 syringes per 28 days
- 0.75 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 5Approval first0.75 mL per 28 days
- 0.88 ML paliperidone palmitate 310 MG/ML Prefilled Syringe [Invega]Tier 5Approval first0.88 mL per 84 days
- 1 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 5Approval first1 syringe per 28 days
- 1 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 5Approval first1 mL per 28 days
- 1.32 ML paliperidone palmitate 311 MG/ML Prefilled Syringe [Invega]Tier 5Approval first1.32 mL per 84 days
- 1.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 5Approval first1.5 syringes per 28 days
- 1.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 5Approval first1.5 mL per 28 days
- 1.75 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 5Approval first1.75 mL per 84 days
- 2.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri]Tier 5Approval first4.5 syringes per 365 days
- 2.63 ML paliperidone palmitate 311 MG/ML Prefilled Syringe [Invega]Tier 5Approval first2.63 mL per 84 days
- 24 HR paliperidone 1.5 MG Extended Release Oral TabletTier 4Approval first1 tablet per 1 days
- 24 HR paliperidone 3 MG Extended Release Oral TabletTier 4Approval first1 tablet per 1 days
- 24 HR paliperidone 6 MG Extended Release Oral TabletTier 4Approval first2 tablets per 1 days
- 24 HR paliperidone 9 MG Extended Release Oral TabletTier 4Approval first1 tablet per 1 days
- 3.5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 5Approval first3.5 mL per 180 days
- 5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 5Approval first5 mL per 180 days