Benefily
Varies by plan

Does Alignment Healthcare require prior authorization for Intralipid?

Prior authorization for Intralipid differs across Alignment Healthcare's Medicare Part D plans and product strengths — 1 of 2 Intralipid 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.

  • 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 productPlans coveringRequire prior authStep therapyQty limitStatus
250 ML soybean oil 200 MG/ML Injection [Intralipid]179970667 / 676700Prior authorization required
soybean oil 300 MG/ML Injectable Suspension [Intralipid]8051310 / 67000Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 250 ML soybean oil 200 MG/ML Injection [Intralipid]

Intralipid has 2 products in the corpus; this table is for 250 ML soybean oil 200 MG/ML Injection [Intralipid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Alignment Health + Intermountain Health (HMO)H9686-0094YesNoNo
Alignment Health Advantage PPO (PPO)H8832-0014YesNoNo
Alignment Health Advantage PPO (PPO)H8832-0024YesNoNo
Alignment Health AllCare Preferred (HMO)H3815-0114YesNoNo
Alignment Health AVA (PPO)H7074-0014YesNoNo
Alignment Health Balance (HMO C-SNP)H3815-0334YesNoNo
Alignment Health Balance (PPO)H4961-0064YesNoNo
Alignment Health BreathEasy (HMO C-SNP)H3815-0414YesNoNo
Alignment Health Clarity (HMO C-SNP)H3815-0424YesNoNo
Alignment Health CommUnity (HMO)H3815-0464YesNoNo
Alignment Health Dual Select+ (HMO-POS D-SNP)H5472-0074YesNoNo
Alignment Health Freedom (PPO)H8832-0034YesNoNo
Alignment Health Harmony (HMO)H3815-0314YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H3443-0034YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H3815-0104YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H9686-0044YesNoNo
Alignment Health Heart & Diabetes (HMO-POS C-SNP)H5472-0024YesNoNo
Alignment Health Heart & Diabetes Access (HMO C-SNP)H3815-0444YesNoNo
Alignment Health Heart & Diabetes AZPlus (HMO C-SNP)H3443-0074YesNoNo
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)H3815-0394YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0484YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0544YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H5296-0114YesNoNo
Alignment Health Heart & Diabetes Choice (HMO C-SNP)H3815-0514YesNoNo
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)H5296-0094YesNoNo
Alignment Health Heart & Diabetes NVPlus (HMO C-SNP)H9686-0064YesNoNo
Alignment Health Heart & Diabetes Plus (HMO C-SNP)H3443-0064YesNoNo
Alignment Health Heart & Diabetes Plus (HMO-POS C-SNP)H5472-0044YesNoNo
Alignment Health Honor+ Plan (HMO)H3815-0524YesNoNo
Alignment Health L.A. Premium Giveback (HMO)H3815-0554YesNoNo
Alignment Health My Choice (HMO)H3815-0014YesNoNo
Alignment Health My Choice (HMO)H3815-0284YesNoNo
Alignment Health My Choice (PPO)H4961-0014YesNoNo
Alignment Health My Choice (PPO)H4961-0034YesNoNo
Alignment Health My Choice CalCare (HMO)H3815-0504YesNoNo
Alignment Health My Choice Select (HMO)H3815-0494YesNoNo
Alignment Health NC Duals (HMO-POS D-SNP)H5296-0044YesNoNo
Alignment Health Platinum (HMO)H5296-0034YesNoNo
Alignment Health Platinum + Instacart (HMO-POS)H3815-0164YesNoNo
Alignment Health Platinum + Instacart (HMO)H3815-0084YesNoNo
Alignment Health Platinum + Instacart (HMO)H5296-0074YesNoNo
Alignment Health Platinum + Instacart (HMO)H9686-0074YesNoNo
Alignment Health Platinum Select (HMO)H5296-0104YesNoNo
Alignment Health S.D. Premium Giveback (HMO)H3815-0564YesNoNo
Alignment Health Silicon (HMO C-SNP)H3815-0454YesNoNo
Alignment Health smartHMO (HMO-POS)H5472-0034YesNoNo
Alignment Health smartHMO (HMO)H3443-0054YesNoNo
Alignment Health smartHMO (HMO)H3815-0134YesNoNo
Alignment Health smartHMO (HMO)H3815-0384YesNoNo
Alignment Health smartHMO (HMO)H3815-0404YesNoNo
Alignment Health smartHMO (HMO)H5296-0064YesNoNo
Alignment Health smartHMO (HMO)H5296-0084YesNoNo
Alignment Health smartHMO (HMO)H9686-0084YesNoNo
Alignment Health smartSavings (HMO-POS)H5472-0104YesNoNo
Alignment Health smartSavings (HMO)H3815-0474YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0194YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0204YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0214YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0234YesNoNo
Alignment Health the ONE (HMO D-SNP)H9686-0054YesNoNo
Alignment Health the ONE (HMO)H3815-0344YesNoNo
Alignment Health the ONE + Walgreens (HMO-POS)H5472-0014YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3443-0014YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3443-0024YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3815-0354YesNoNo
Alignment Health Total Dual+ (HMO-POS D-SNP)H5472-0094YesNoNo
Alignment Health ValorCare (HMO)H3815-0534YesNoNo
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
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.

Intralipid at other payers

Or see Intralipid 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.