Does Aetna (CVS Health) require prior authorization for Emgality?
Prior authorization for Emgality differs across Aetna (CVS Health)'s Medicare Part D plans and product strengths — 3 of 3 Emgality products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.
Some plans require authorization and others do not. The member's specific plan decides.
- Prior authorization requirements differ across this payer's plans: 12 of 22 covering plans require it. Check the specific plan the member is enrolled in — the plan name and contract number are on their insurance card.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]2058877 | 22 / 658 | 12 | 0 | 12 | Varies by plan |
| 1 ML galcanezumab-gnlm 120 MG/ML Prefilled Syringe [Emgality]2058887 | 22 / 658 | 12 | 0 | 12 | Varies by plan |
| 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]2170613 | 22 / 658 | 12 | 0 | 12 | Varies by plan |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]
Emgality has 3 products in the corpus; this table is for 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Community First Medicare Advantage Alamo Plan (HMO) | H5447-001 | 3 | Yes | No | Yes |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | H5447-002 | 3 | Yes | No | Yes |
| El Paso Health Giveback (HMO) | H3407-003 | 3 | Yes | No | Yes |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | H3407-001 | 3 | Yes | No | Yes |
| El Paso Health Total (HMO) | H3407-002 | 3 | Yes | No | Yes |
| Health First Classic H1099-001 (HMO-POS) | H1099-001 | 3 | No | No | No |
| Health First Complete Care H1099-023 (HMO) | H1099-023 | 3 | No | No | No |
| Health First Emerald Plus H1099-024 (HMO) | H1099-024 | 3 | No | No | No |
| Health First Emerald Plus H1099-026 (HMO) | H1099-026 | 3 | No | No | No |
| Health First Emerald Plus H1099-028 (HMO) | H1099-028 | 3 | No | No | No |
| Health First Premier Access H1099-025 (HMO-POS) | H1099-025 | 3 | No | No | No |
| Health First Premier Access H1099-027 (HMO-POS) | H1099-027 | 3 | No | No | No |
| Health First Rewards H1099-014 (HMO) | H1099-014 | 3 | No | No | No |
| Health First SunSaver H1099-016 (HMO) | H1099-016 | 3 | No | No | No |
| Health First Value H1099-006 (HMO) | H1099-006 | 3 | No | No | No |
| Healthfirst 65 Plus Plan (HMO) | H3359-001 | 3 | Yes | No | Yes |
| Healthfirst CompleteCare (HMO D-SNP) | H3359-034 | 1 | Yes | No | Yes |
| Healthfirst Connection Plan (HMO D-SNP) | H3359-038 | 3 | Yes | No | Yes |
| Healthfirst Increased Benefits Plan (HMO) | H3359-019 | 3 | Yes | No | Yes |
| Healthfirst Life Improvement Plan (HMO D-SNP) | H3359-021 | 3 | Yes | No | Yes |
| Healthfirst Signature (HMO) | H1722-002 | 3 | Yes | No | Yes |
| Healthfirst Signature (HMO) | H5989-011 | 3 | Yes | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.
Emgality at other payers
Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.