Does Clover Health require prior authorization for Humulin R?
Prior authorization for Humulin R differs across Clover Health's Medicare Part D plans and product strengths — 3 of 3 Humulin R products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.
Some plans require authorization and others do not. The member's specific plan decides.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 3 ML insulin, regular, human 500 UNT/ML Pen Injector [Humulin R]1731317 | 13 / 13 | 0 | 0 | 0 | No prior authorization |
| insulin, regular, human 100 UNT/ML Injectable Solution [Humulin R]311036 | 7 / 13 | 7 | 0 | 0 | Prior authorization required |
| insulin, regular, human 500 UNT/ML Injectable Solution [Humulin R]351859 | 13 / 13 | 13 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 3 ML insulin, regular, human 500 UNT/ML Pen Injector [Humulin R]
Humulin R has 3 products in the corpus; this table is for 3 ML insulin, regular, human 500 UNT/ML Pen Injector [Humulin R], 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 | 5 | No | No | No |
| Clover Health Choice (PPO) | H5141-025 | 5 | No | No | No |
| Clover Health Choice (PPO) | H5141-032 | 5 | No | No | No |
| Clover Health Choice (PPO) | H5141-038 | 5 | No | No | No |
| Clover Health Choice Giveback (PPO) | H5141-054 | 5 | No | No | No |
| Clover Health Choice Value (PPO) | H5141-007 | 5 | No | No | No |
| Clover Health Choice Value (PPO) | H5141-042 | 5 | No | No | No |
| Clover Health Classic (HMO) | H8010-002 | 5 | No | No | No |
| Clover Health LiveHealthy (PPO) | H5141-026 | 5 | No | No | No |
| Clover Health LiveHealthy (PPO) | H5141-036 | 5 | No | No | No |
| Clover Health LiveHealthy Giveback (PPO) | H5141-063 | 5 | No | No | No |
| Clover Health LiveHealthy Value (PPO) | H5141-045 | 5 | No | No | No |
| Clover Health Value (HMO) | H8010-003 | 5 | No | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Humulin R 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.