For US Health Care Professionals
ENTRESTO® Coverage
Comprehensive information on health plan coverage, prior authorization requirements, and PA forms. Helping your patients get access to ENTRESTO is as easy as 1, 2, 3.
This site is intended for US health care office staff.
Find Your Patient's Coverage Information for ENTRESTO
Select a state and multiple plan types to view a list of plans.
STATE
PLAN TYPES
SELECT A PLAN
A list of plans will appear once you have selected a state and plan type.
The coverage and prior authorization (PA) requirements listed here are representations by Zitter Health Insights of the actual criteria developed and approved by managed care organizations and are not controlled by Novartis Pharmaceuticals Corporation (NPC). Coverage information is subject to change by the relevant plan. NPC has not independently verified the requirements of each plan and assumes no responsibility for this content. NPC cannot guarantee payment of any claim. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims. It is the sole responsibility of the health care provider to select the proper code and ensure the accuracy of all claims used in seeking reimbursement.
Please note: In this tool, qualified health plans available through health insurance marketplaces are considered commercial plans.
Reference: Data on file. Zitter Health Insights. Policy & Access Tracking Tool. Novartis Pharmaceuticals Corp. East Hanover, NJ.
Review Coverage Details for ENTRESTO
Learn about the coverage information and PA requirements for the plan you selected.
[Plan name dynamically populated]
COVERAGE
State: | |
Type of Plan: | |
Name of Payer: |
State: | Name of Payer: |
Type of Plan: | PA Required?: |
Formulary Tier: | Number of Formulary Tiers: |
Step Therapy Required?: | Step Therapy Placement: |
Quantity Limits: |
PA Requirements |
NYHA Class Requirements |
LVEF Requirements |
Specialist Approval Required? |
Concomitant Therapy Requirements |
Proof of Effectiveness Required? |
Lab Requirements |
Dose Limits |
Length of Initial Authorization |
LVEF, left ventricular ejection fraction; NYHA, New York Heart Association.
NOT COVERED
The coverage and prior authorization (PA) requirements listed here are representations by Zitter Health Insights of the actual criteria developed and approved by managed care organizations and are not controlled by Novartis Pharmaceuticals Corporation (NPC). Coverage information is subject to change by the relevant plan. NPC has not independently verified the requirements of each plan and assumes no responsibility for this content. NPC cannot guarantee payment of any claim. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims. It is the sole responsibility of the health care provider to select the proper code and ensure the accuracy of all claims used in seeking reimbursement.
Please note: In this tool, qualified health plans available through health insurance marketplaces are considered commercial plans.
Reference: Data on file. Zitter Health Insights. Policy & Access Tracking Tool. Novartis Pharmaceuticals Corp. East Hanover, NJ.
Access the Plan-Specific PA Form for ENTRESTO
Click on the link to access the plan’s PA form.
Access PA FormMore PA Information
No PA form is available at this time.
Access the Plan-Specific PA Form for ENTRESTO
No PA required.
Resources Are Available to Help Patients Access ENTRESTO
Click on the link to access the plan-specific information to request coverage for ENTRESTO.
1-888-ENTRESTO
Support for Appeal Coverage Denials
- Need information on filing an appeal if a patient does not have coverage for ENTRESTO?
Call 1-888-ENTRESTO Monday through Friday
(excluding holidays), 9:00 AM to 8:00 PM ET - Wide range of patient support services available
- Enroll your patients today