Benefily
No prior authorization

Does Cariten Health Plan INC. require prior authorization for Trijardy?

Cariten Health Plan INC. does not require prior authorization for Trijardy on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235928544 / 440044No prior authorization
24 HR empagliflozin 12.5 MG / linagliptin 2.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235929044 / 440044No prior authorization
24 HR empagliflozin 25 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235935344 / 440044No prior authorization
24 HR empagliflozin 5 MG / linagliptin 2.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235935844 / 440044No prior authorization

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

Plan-by-plan detail — 24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]

Trijardy has 4 products in the corpus; this table is for 24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Humana Community (HMO-POS)H4461-0483NoNoYes
Humana Dual Select H4461-077 (HMO D-SNP)H4461-0773NoNoYes
Humana Essentials Plus Giveback H4461-039 (HMO)H4461-0393NoNoYes
Humana Essentials Plus Giveback H4461-045 (HMO)H4461-0453NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0423NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0633NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0653NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0663NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0673NoNoYes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)H4461-0683NoNoYes
Humana Gold Plus H4461-025 (HMO)H4461-0253NoNoYes
Humana Gold Plus H4461-035 (HMO)H4461-0353NoNoYes
Humana Gold Plus H4461-040 (HMO)H4461-0403NoNoYes
Humana Gold Plus H4461-041 (HMO)H4461-0413NoNoYes
Humana Gold Plus H4461-050 (HMO)H4461-0503NoNoYes
Humana Gold Plus H4461-052 (HMO)H4461-0523NoNoYes
Humana Gold Plus H4461-053 (HMO)H4461-0533NoNoYes
Humana Gold Plus H4461-054 (HMO)H4461-0543NoNoYes
Humana Gold Plus H4461-055 (HMO)H4461-0553NoNoYes
Humana Gold Plus H4461-056 (HMO)H4461-0563NoNoYes
Humana Gold Plus H4461-057 (HMO)H4461-0573NoNoYes
Humana Gold Plus H4461-058 (HMO)H4461-0583NoNoYes
Humana Gold Plus H4461-059 (HMO)H4461-0593NoNoYes
Humana Gold Plus H4461-060 (HMO)H4461-0603NoNoYes
Humana Gold Plus H4461-061 (HMO)H4461-0613NoNoYes
Humana Gold Plus H4461-062 (HMO)H4461-0623NoNoYes
Humana Gold Plus H4461-073 (HMO)H4461-0733NoNoYes
Humana Gold Plus H4461-078 (HMO)H4461-0783NoNoYes
Humana Gold Plus H4461-079 (HMO)H4461-0793NoNoYes
Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP)H4461-0383NoNoYes
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP)H4461-0443NoNoYes
Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP)H4461-0693NoNoYes
Humana Gold Plus SNP-DE H4461-070 (HMO D-SNP)H4461-0703NoNoYes
Humana Gold Plus SNP-DE H4461-071 (HMO D-SNP)H4461-0713NoNoYes
Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP)H4461-0723NoNoYes
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP)H4461-0743NoNoYes
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP)H4461-0763NoNoYes
Humana Total Complete Giveback H4461-047 (HMO-POS)H4461-0473NoNoYes
Humana Total Complete H4461-043 (HMO)H4461-0433NoNoYes
Humana Total Complete H4461-043 (HMO)H4461-0433NoNoYes
Humana Total Complete H4461-046 (HMO)H4461-0463NoNoYes
Humana Total Complete H4461-049 (HMO)H4461-0493NoNoYes
Humana Total Complete H4461-051 (HMO)H4461-0513NoNoYes
Humana Total Complete H4461-064 (HMO)H4461-0643NoNoYes
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.

Trijardy at other payers

Or see Trijardy 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.