FillMapEmblemHealth VIP Dual Enhanced (HMO D-SNP)

Does EmblemHealth VIP Dual Enhanced (HMO D-SNP) cover paliperidone?

EmblemHealth VIP Dual Enhanced (HMO D-SNP)
H5991-013-2 · MA_LOCAL · Medicare Part D
paliperidone
Your Extra Help level

Everyone on this plan has Medicare and Medicaid, which qualifies you for Extra Help automatically — so the figures below already use the statutory copays, not this plan’s published cost sharing. Nothing here is saved.

Full Extra Help: no deductible, and at most $5.10 generic or $12.65 brand-name per fill.

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 EmblemHealth VIP Dual Enhanced (HMO D-SNP)
Covered — some forms require prior authorization
4 of 15 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$0per 30-day fill

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 $615 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 (15)

  • 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 40.25 mL per 28 days
  • 0.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 50.5 mL per 28 days
  • 0.75 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 50.75 mL per 28 days
  • 0.88 ML paliperidone palmitate 310 MG/ML Prefilled Syringe [Invega]Tier 50.88 mL per 84 days
  • 1 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 51 mL per 28 days
  • 1.32 ML paliperidone palmitate 311 MG/ML Prefilled Syringe [Invega]Tier 51.32 mL per 84 days
  • 1.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega]Tier 51.5 mL per 28 days
  • 1.75 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 51.75 mL per 84 days
  • 2.63 ML paliperidone palmitate 311 MG/ML Prefilled Syringe [Invega]Tier 52.63 mL per 84 days
  • 24 HR paliperidone 1.5 MG Extended Release Oral TabletTier 4Approval first30 tablets per 30 days
  • 24 HR paliperidone 3 MG Extended Release Oral TabletTier 4Approval first30 tablets per 30 days
  • 24 HR paliperidone 6 MG Extended Release Oral TabletTier 4Approval first60 tablets per 30 days
  • 24 HR paliperidone 9 MG Extended Release Oral TabletTier 4Approval first30 tablets per 30 days
  • 3.5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 53.5 mL per 180 days
  • 5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega]Tier 55 mL per 180 days

← All coverage for paliperidone