Benefily
Prior authorization required

Does California Physicians' Service require prior authorization for Emgality?

California Physicians' Service requires prior authorization for Emgality 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 productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]205887717 / 1717017Prior authorization required
1 ML galcanezumab-gnlm 120 MG/ML Prefilled Syringe [Emgality]205888717 / 1717017Prior authorization required
1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]217061317 / 1717017Prior authorization required

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

Plan-by-plan detail — 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]

Emgality has 3 products in the corpus; this table is for 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Shield 65 Plus (HMO)H0504-0153YesNoYes
Blue Shield 65 Plus (HMO)H0504-0173YesNoYes
Blue Shield 65 Plus (HMO)H0504-0263YesNoYes
Blue Shield 65 Plus (HMO)H0504-0283YesNoYes
Blue Shield 65 Plus (HMO)H0504-0383YesNoYes
Blue Shield 65 Plus (HMO)H0504-0393YesNoYes
Blue Shield 65 Plus Choice Plan (HMO)H0504-0403YesNoYes
Blue Shield 65 Plus Plan 2 (HMO)H0504-0213YesNoYes
Blue Shield Advantage (HMO)H0504-0503YesNoYes
Blue Shield AdvantageOptimum Plan (HMO)H5928-0043YesNoYes
Blue Shield AdvantageOptimum Plan 1 (HMO)H5928-0103YesNoYes
Blue Shield Inspire (HMO)H0504-0413YesNoYes
Blue Shield Inspire (HMO)H0504-0433YesNoYes
Blue Shield Inspire (HMO)H0504-0473YesNoYes
Blue Shield Rx Enhanced (PDP)S2468-0043YesNoYes
Blue Shield Rx Plus (PDP)S2468-0033YesNoYes
Blue Shield TotalDual Plan (HMO D-SNP)H2819-0013YesNoYes
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.

Emgality at other payers

Or see Emgality 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.