Does Alignment Healthcare require prior authorization for Creon?
Alignment Healthcare does not require prior authorization for Creon on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
- This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| amylase 15000 UNT / lipase 3000 UNT / protease 9500 UNT Delayed Release Oral Capsule [Creon]1113046 | 67 / 67 | 0 | 0 | 0 | No prior authorization |
| amylase 180000 UNT / lipase 36000 UNT / protease 114000 UNT Delayed Release Oral Capsule [Creon]1373327 | 67 / 67 | 0 | 0 | 0 | No prior authorization |
| amylase 120000 UNT / lipase 24000 UNT / protease 76000 UNT Delayed Release Oral Capsule [Creon]863829 | 67 / 67 | 0 | 0 | 0 | No prior authorization |
| amylase 30000 UNT / lipase 6000 UNT / protease 19000 UNT Delayed Release Oral Capsule [Creon]863836 | 0 / 67 | 0 | 0 | 0 | Not on formulary |
| amylase 60000 UNT / lipase 12000 UNT / protease 38000 UNT Delayed Release Oral Capsule [Creon]863841 | 0 / 67 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — amylase 15000 UNT / lipase 3000 UNT / protease 9500 UNT Delayed Release Oral Capsule [Creon]
Creon has 5 products in the corpus; this table is for amylase 15000 UNT / lipase 3000 UNT / protease 9500 UNT Delayed Release Oral Capsule [Creon], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Alignment Health + Intermountain Health (HMO) | H9686-009 | 3 | No | No | No |
| Alignment Health Advantage PPO (PPO) | H8832-001 | 3 | No | No | No |
| Alignment Health Advantage PPO (PPO) | H8832-002 | 3 | No | No | No |
| Alignment Health AllCare Preferred (HMO) | H3815-011 | 3 | No | No | No |
| Alignment Health AVA (PPO) | H7074-001 | 3 | No | No | No |
| Alignment Health Balance (HMO C-SNP) | H3815-033 | 3 | No | No | No |
| Alignment Health Balance (PPO) | H4961-006 | 3 | No | No | No |
| Alignment Health BreathEasy (HMO C-SNP) | H3815-041 | 3 | No | No | No |
| Alignment Health Clarity (HMO C-SNP) | H3815-042 | 3 | No | No | No |
| Alignment Health CommUnity (HMO) | H3815-046 | 3 | No | No | No |
| Alignment Health Dual Select+ (HMO-POS D-SNP) | H5472-007 | 3 | No | No | No |
| Alignment Health Freedom (PPO) | H8832-003 | 3 | No | No | No |
| Alignment Health Harmony (HMO) | H3815-031 | 3 | No | No | No |
| Alignment Health Heart & Diabetes (HMO C-SNP) | H3443-003 | 3 | No | No | No |
| Alignment Health Heart & Diabetes (HMO C-SNP) | H3815-010 | 3 | No | No | No |
| Alignment Health Heart & Diabetes (HMO C-SNP) | H9686-004 | 3 | No | No | No |
| Alignment Health Heart & Diabetes (HMO-POS C-SNP) | H5472-002 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Access (HMO C-SNP) | H3815-044 | 3 | No | No | No |
| Alignment Health Heart & Diabetes AZPlus (HMO C-SNP) | H3443-007 | 3 | No | No | No |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | H3815-039 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | H3815-048 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | H3815-054 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | H5296-011 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | H3815-051 | 3 | No | No | No |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | H5296-009 | 3 | No | No | No |
| Alignment Health Heart & Diabetes NVPlus (HMO C-SNP) | H9686-006 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Plus (HMO C-SNP) | H3443-006 | 3 | No | No | No |
| Alignment Health Heart & Diabetes Plus (HMO-POS C-SNP) | H5472-004 | 3 | No | No | No |
| Alignment Health Honor+ Plan (HMO) | H3815-052 | 3 | No | No | No |
| Alignment Health L.A. Premium Giveback (HMO) | H3815-055 | 3 | No | No | No |
| Alignment Health My Choice (HMO) | H3815-001 | 3 | No | No | No |
| Alignment Health My Choice (HMO) | H3815-028 | 3 | No | No | No |
| Alignment Health My Choice (PPO) | H4961-001 | 3 | No | No | No |
| Alignment Health My Choice (PPO) | H4961-003 | 3 | No | No | No |
| Alignment Health My Choice CalCare (HMO) | H3815-050 | 3 | No | No | No |
| Alignment Health My Choice Select (HMO) | H3815-049 | 3 | No | No | No |
| Alignment Health NC Duals (HMO-POS D-SNP) | H5296-004 | 3 | No | No | No |
| Alignment Health Platinum (HMO) | H5296-003 | 3 | No | No | No |
| Alignment Health Platinum + Instacart (HMO-POS) | H3815-016 | 3 | No | No | No |
| Alignment Health Platinum + Instacart (HMO) | H3815-008 | 3 | No | No | No |
| Alignment Health Platinum + Instacart (HMO) | H5296-007 | 3 | No | No | No |
| Alignment Health Platinum + Instacart (HMO) | H9686-007 | 3 | No | No | No |
| Alignment Health Platinum Select (HMO) | H5296-010 | 3 | No | No | No |
| Alignment Health S.D. Premium Giveback (HMO) | H3815-056 | 3 | No | No | No |
| Alignment Health Silicon (HMO C-SNP) | H3815-045 | 3 | No | No | No |
| Alignment Health smartHMO (HMO-POS) | H5472-003 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H3443-005 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H3815-013 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H3815-038 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H3815-040 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H5296-006 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H5296-008 | 3 | No | No | No |
| Alignment Health smartHMO (HMO) | H9686-008 | 3 | No | No | No |
| Alignment Health smartSavings (HMO-POS) | H5472-010 | 3 | No | No | No |
| Alignment Health smartSavings (HMO) | H3815-047 | 3 | No | No | No |
| Alignment Health Sutter Advantage +More (HMO) | H3815-019 | 3 | No | No | No |
| Alignment Health Sutter Advantage +More (HMO) | H3815-020 | 3 | No | No | No |
| Alignment Health Sutter Advantage +More (HMO) | H3815-021 | 3 | No | No | No |
| Alignment Health Sutter Advantage +More (HMO) | H3815-023 | 3 | No | No | No |
| Alignment Health the ONE (HMO D-SNP) | H9686-005 | 3 | No | No | No |
| Alignment Health the ONE (HMO) | H3815-034 | 3 | No | No | No |
| Alignment Health the ONE + Walgreens (HMO-POS) | H5472-001 | 3 | No | No | No |
| Alignment Health the ONE + Walgreens (HMO) | H3443-001 | 3 | No | No | No |
| Alignment Health the ONE + Walgreens (HMO) | H3443-002 | 3 | No | No | No |
| Alignment Health the ONE + Walgreens (HMO) | H3815-035 | 3 | No | No | No |
| Alignment Health Total Dual+ (HMO-POS D-SNP) | H5472-009 | 3 | No | No | No |
| Alignment Health ValorCare (HMO) | H3815-053 | 3 | No | No | No |
- 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.
Creon at other payers
Or see Creon across every payer at once.
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.