Prior authorization required

Does Alignment Healthcare require prior authorization for Retacrit?

Alignment Healthcare requires prior authorization for Retacrit on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm product	Plans covering	Require prior auth	Status
1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit]2047596	67 / 67	67	Prior authorization required
1 ML epoetin alfa-epbx 2000 UNT/ML Injection [Retacrit]2047602	67 / 67	67	Prior authorization required
1 ML epoetin alfa-epbx 3000 UNT/ML Injection [Retacrit]2047608	67 / 67	67	Prior authorization required
1 ML epoetin alfa-epbx 4000 UNT/ML Injection [Retacrit]2047614	67 / 67	67	Prior authorization required
1 ML epoetin alfa-epbx 40000 UNT/ML Injection [Retacrit]2047623	67 / 67	67	Prior authorization required
epoetin alfa-epbx 10000 UNT/ML Injectable Solution [Retacrit]2463733	67 / 67	67	Prior authorization required
epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]2463737	67 / 67	67	Prior authorization required

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

Plan-by-plan detail — 1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit]

Retacrit has 7 products in the corpus; this table is for 1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit], 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	4	Yes	No	No
Alignment Health Advantage PPO (PPO)	H8832-001	4	Yes	No	No
Alignment Health Advantage PPO (PPO)	H8832-002	4	Yes	No	No
Alignment Health AllCare Preferred (HMO)	H3815-011	4	Yes	No	No
Alignment Health AVA (PPO)	H7074-001	4	Yes	No	No
Alignment Health Balance (HMO C-SNP)	H3815-033	4	Yes	No	No
Alignment Health Balance (PPO)	H4961-006	4	Yes	No	No
Alignment Health BreathEasy (HMO C-SNP)	H3815-041	4	Yes	No	No
Alignment Health Clarity (HMO C-SNP)	H3815-042	4	Yes	No	No
Alignment Health CommUnity (HMO)	H3815-046	4	Yes	No	No
Alignment Health Dual Select+ (HMO-POS D-SNP)	H5472-007	4	Yes	No	No
Alignment Health Freedom (PPO)	H8832-003	4	Yes	No	No
Alignment Health Harmony (HMO)	H3815-031	4	Yes	No	No
Alignment Health Heart & Diabetes (HMO C-SNP)	H3443-003	4	Yes	No	No
Alignment Health Heart & Diabetes (HMO C-SNP)	H3815-010	4	Yes	No	No
Alignment Health Heart & Diabetes (HMO C-SNP)	H9686-004	4	Yes	No	No
Alignment Health Heart & Diabetes (HMO-POS C-SNP)	H5472-002	4	Yes	No	No
Alignment Health Heart & Diabetes Access (HMO C-SNP)	H3815-044	4	Yes	No	No
Alignment Health Heart & Diabetes AZPlus (HMO C-SNP)	H3443-007	4	Yes	No	No
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)	H3815-039	4	Yes	No	No
Alignment Health Heart & Diabetes Care (HMO C-SNP)	H3815-048	4	Yes	No	No
Alignment Health Heart & Diabetes Care (HMO C-SNP)	H3815-054	4	Yes	No	No
Alignment Health Heart & Diabetes Care (HMO C-SNP)	H5296-011	4	Yes	No	No
Alignment Health Heart & Diabetes Choice (HMO C-SNP)	H3815-051	4	Yes	No	No
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)	H5296-009	4	Yes	No	No
Alignment Health Heart & Diabetes NVPlus (HMO C-SNP)	H9686-006	4	Yes	No	No
Alignment Health Heart & Diabetes Plus (HMO C-SNP)	H3443-006	4	Yes	No	No
Alignment Health Heart & Diabetes Plus (HMO-POS C-SNP)	H5472-004	4	Yes	No	No
Alignment Health Honor+ Plan (HMO)	H3815-052	4	Yes	No	No
Alignment Health L.A. Premium Giveback (HMO)	H3815-055	4	Yes	No	No
Alignment Health My Choice (HMO)	H3815-001	4	Yes	No	No
Alignment Health My Choice (HMO)	H3815-028	4	Yes	No	No
Alignment Health My Choice (PPO)	H4961-001	4	Yes	No	No
Alignment Health My Choice (PPO)	H4961-003	4	Yes	No	No
Alignment Health My Choice CalCare (HMO)	H3815-050	4	Yes	No	No
Alignment Health My Choice Select (HMO)	H3815-049	4	Yes	No	No
Alignment Health NC Duals (HMO-POS D-SNP)	H5296-004	4	Yes	No	No
Alignment Health Platinum (HMO)	H5296-003	4	Yes	No	No
Alignment Health Platinum + Instacart (HMO-POS)	H3815-016	4	Yes	No	No
Alignment Health Platinum + Instacart (HMO)	H3815-008	4	Yes	No	No
Alignment Health Platinum + Instacart (HMO)	H5296-007	4	Yes	No	No
Alignment Health Platinum + Instacart (HMO)	H9686-007	4	Yes	No	No
Alignment Health Platinum Select (HMO)	H5296-010	4	Yes	No	No
Alignment Health S.D. Premium Giveback (HMO)	H3815-056	4	Yes	No	No
Alignment Health Silicon (HMO C-SNP)	H3815-045	4	Yes	No	No
Alignment Health smartHMO (HMO-POS)	H5472-003	4	Yes	No	No
Alignment Health smartHMO (HMO)	H3443-005	4	Yes	No	No
Alignment Health smartHMO (HMO)	H3815-013	4	Yes	No	No
Alignment Health smartHMO (HMO)	H3815-038	4	Yes	No	No
Alignment Health smartHMO (HMO)	H3815-040	4	Yes	No	No
Alignment Health smartHMO (HMO)	H5296-006	4	Yes	No	No
Alignment Health smartHMO (HMO)	H5296-008	4	Yes	No	No
Alignment Health smartHMO (HMO)	H9686-008	4	Yes	No	No
Alignment Health smartSavings (HMO-POS)	H5472-010	4	Yes	No	No
Alignment Health smartSavings (HMO)	H3815-047	4	Yes	No	No
Alignment Health Sutter Advantage +More (HMO)	H3815-019	4	Yes	No	No
Alignment Health Sutter Advantage +More (HMO)	H3815-020	4	Yes	No	No
Alignment Health Sutter Advantage +More (HMO)	H3815-021	4	Yes	No	No
Alignment Health Sutter Advantage +More (HMO)	H3815-023	4	Yes	No	No
Alignment Health the ONE (HMO D-SNP)	H9686-005	4	Yes	No	No
Alignment Health the ONE (HMO)	H3815-034	4	Yes	No	No
Alignment Health the ONE + Walgreens (HMO-POS)	H5472-001	4	Yes	No	No
Alignment Health the ONE + Walgreens (HMO)	H3443-001	4	Yes	No	No
Alignment Health the ONE + Walgreens (HMO)	H3443-002	4	Yes	No	No
Alignment Health the ONE + Walgreens (HMO)	H3815-035	4	Yes	No	No
Alignment Health Total Dual+ (HMO-POS D-SNP)	H5472-009	4	Yes	No	No
Alignment Health ValorCare (HMO)	H3815-053	4	Yes	No	No

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.

Retacrit at other payers

Or see Retacrit 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.