Prior authorization required

Does Central Health Plan Of California, INC. require prior authorization for Doptelet?

Central Health Plan Of California, INC. 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	15 / 15	15	0	0	Prior authorization required
avatrombopag 10 MG Oral Granules [Doptelet]2721192	15 / 15	15	0	0	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
Central Health Classic Care Plan I (HMO)	H5649-027	5	Yes	No	No
Central Health Classic Care Plan II (HMO)	H5649-028	5	Yes	No	No
Central Health Classic Care Plan III (HMO)	H5649-023	5	Yes	No	No
Central Health Classic Care Plan IV (HMO)	H5649-018	5	Yes	No	No
Central Health Embrace Care Plan (HMO C-SNP)	H5649-025	5	Yes	No	No
Central Health Embrace Care Plan (HMO C-SNP)	H5649-025	5	Yes	No	No
Central Health Embrace Care Plan (HMO C-SNP)	H5649-025	5	Yes	No	No
Central Health Embrace Care Plan (HMO C-SNP)	H5649-025	5	Yes	No	No
Central Health Embrace Choice Plan (HMO C-SNP)	H5649-026	5	Yes	No	No
Central Health Embrace Choice Plan (HMO C-SNP)	H5649-026	5	Yes	No	No
Central Health Embrace Choice Plan (HMO C-SNP)	H5649-026	5	Yes	No	No
Central Health Embrace Choice Plan (HMO C-SNP)	H5649-026	5	Yes	No	No
Central Health Jade Plan (HMO)	H5649-022	5	Yes	No	No
Central Health Medicare Plan (HMO)	H5649-001	5	Yes	No	No
Central Health Part B Savings Plan (HMO)	H5649-029	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.