Prior authorization required

Does Blue Cross Blue Shield (affiliate) require prior authorization for Doptelet?

Blue Cross Blue Shield (affiliate) requires prior authorization for Doptelet 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	Step therapy	Qty limit	Status
avatrombopag 20 MG Oral Tablet [Doptelet]2045958	21 / 269	21	0	3	Prior authorization required
avatrombopag 10 MG Oral Granules [Doptelet]2721192	21 / 269	21	0	3	Prior authorization required

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

Plan-by-plan detail — avatrombopag 20 MG Oral Tablet [Doptelet]

Doptelet has 2 products in the corpus; this table is for avatrombopag 20 MG Oral Tablet [Doptelet], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Blue Medicare Advantage Classic PPO (PPO)	H5900-008	5	Yes	No	No
Blue Medicare Advantage Enhanced PPO (PPO)	H5900-004	5	Yes	No	No
Blue Medicare Advantage PPO (PPO)	H5900-001	5	Yes	No	No
Blue Medicare Rx Enhanced (PDP)	S5540-004	5	Yes	No	No
Blue MedicareRx Plus (PDP)	S5726-014	5	Yes	No	No
CareFirst BlueCross BlueShield Advantage Complete (PPO)	H7379-002	5	Yes	No	No
CareFirst BlueCross BlueShield Advantage DualPrime (HMO D-SNP)	H8854-002	5	Yes	No	No
CareFirst BlueCross BlueShield Advantage Essential (PPO)	H7379-001	5	Yes	No	No
Highmark Health Options Duals (HMO D-SNP)	H6224-001	1	Yes	No	Yes
Highmark Health Options Duals (HMO D-SNP)	H7710-001	1	Yes	No	Yes
Highmark Health Options Duals Select (HMO D-SNP)	H7710-002	1	Yes	No	Yes
Medicare HMO Blue FlexRx (HMO-POS)	H2261-023	5	Yes	No	No
Medicare HMO Blue FlexRx (HMO-POS)	H2261-023	5	Yes	No	No
Medicare HMO Blue PlusRx (HMO)	H2261-005	5	Yes	No	No
Medicare HMO Blue SaverRx (HMO-POS)	H2261-024	5	Yes	No	No
Medicare HMO Blue ValueRx (HMO)	H2261-022	5	Yes	No	No
Medicare HMO Blue ValueRx (HMO)	H2261-022	5	Yes	No	No
Medicare PPO Blue EssentialRx (PPO)	H2230-019	5	Yes	No	No
Medicare PPO Blue PlusRx (PPO)	H2230-002	5	Yes	No	No
Medicare PPO Blue ValueRx (PPO)	H2230-018	5	Yes	No	No
Medicare PPO Blue ValueRx (PPO)	H2230-018	5	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.

Doptelet at other payers

Or see Doptelet 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.