Benefily
Prior authorization required

Does Clover Health require prior authorization for Intralipid?

Clover Health requires prior authorization for Intralipid 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
250 ML soybean oil 200 MG/ML Injection [Intralipid]179970613 / 131300Prior authorization required
soybean oil 300 MG/ML Injectable Suspension [Intralipid]80513113 / 131300Prior authorization required

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

Plan-by-plan detail — 250 ML soybean oil 200 MG/ML Injection [Intralipid]

Intralipid has 2 products in the corpus; this table is for 250 ML soybean oil 200 MG/ML Injection [Intralipid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Clover Health Choice (PPO)H5141-0044YesNoNo
Clover Health Choice (PPO)H5141-0254YesNoNo
Clover Health Choice (PPO)H5141-0324YesNoNo
Clover Health Choice (PPO)H5141-0384YesNoNo
Clover Health Choice Giveback (PPO)H5141-0544YesNoNo
Clover Health Choice Value (PPO)H5141-0074YesNoNo
Clover Health Choice Value (PPO)H5141-0424YesNoNo
Clover Health Classic (HMO)H8010-0024YesNoNo
Clover Health LiveHealthy (PPO)H5141-0264YesNoNo
Clover Health LiveHealthy (PPO)H5141-0364YesNoNo
Clover Health LiveHealthy Giveback (PPO)H5141-0634YesNoNo
Clover Health LiveHealthy Value (PPO)H5141-0454YesNoNo
Clover Health Value (HMO)H8010-0034YesNoNo
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.

Intralipid at other payers

Or see Intralipid 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.