Does Bravo Health Mid-Atlantic, INC. require prior authorization for Bicillin L-A?
Bravo Health Mid-Atlantic, INC. requires prior authorization for Bicillin L-A 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 |
|---|---|---|---|---|---|
| 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731566 | 7 / 7 | 7 | 0 | 0 | Prior authorization required |
| 2 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731568 | 7 / 7 | 7 | 0 | 0 | Prior authorization required |
| 4 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731571 | 7 / 7 | 7 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]
Bicillin L-A has 3 products in the corpus; this table is for 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| HealthSpring Achieve (HMO C-SNP) | H2108-029 | 4 | Yes | No | No |
| HealthSpring Achieve (HMO C-SNP) | H2108-030 | 4 | Yes | No | No |
| HealthSpring Alliance (HMO) | H2108-036 | 4 | Yes | No | No |
| HealthSpring Preferred (HMO) | H2108-042 | 4 | Yes | No | No |
| HealthSpring Preferred (HMO) | H2108-042 | 4 | Yes | No | No |
| HealthSpring Preferred Plus (HMO) | H2108-022 | 4 | Yes | No | No |
| HealthSpring TotalCare Plus (HMO D-SNP) | H2108-041 | 4 | Yes | 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.
Bicillin L-A 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.