Does Clover Health require prior authorization for Breo?
Clover Health does not require prior authorization for Breo 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo]1539893 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 30 ACTUAT fluticasone furoate 0.2 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo]1648789 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 30 ACTUAT fluticasone furoate 0.05 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo]2637476 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo]
Breo has 3 products in the corpus; this table is for 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Breo], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Clover Health Choice (PPO) | H5141-004 | 3 | No | No | Yes |
| Clover Health Choice (PPO) | H5141-025 | 3 | No | No | Yes |
| Clover Health Choice (PPO) | H5141-032 | 3 | No | No | Yes |
| Clover Health Choice (PPO) | H5141-038 | 3 | No | No | Yes |
| Clover Health Choice Giveback (PPO) | H5141-054 | 3 | No | No | Yes |
| Clover Health Choice Value (PPO) | H5141-007 | 3 | No | No | Yes |
| Clover Health Choice Value (PPO) | H5141-042 | 3 | No | No | Yes |
| Clover Health Classic (HMO) | H8010-002 | 3 | No | No | Yes |
| Clover Health LiveHealthy (PPO) | H5141-026 | 3 | No | No | Yes |
| Clover Health LiveHealthy (PPO) | H5141-036 | 3 | No | No | Yes |
| Clover Health LiveHealthy Giveback (PPO) | H5141-063 | 3 | No | No | Yes |
| Clover Health LiveHealthy Value (PPO) | H5141-045 | 3 | No | No | Yes |
| Clover Health Value (HMO) | H8010-003 | 3 | No | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Breo at other payers
Or see Breo 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.