Benefily
Varies by plan

Does Community Care Health Plan, INC. require prior authorization for Mavyret?

Prior authorization for Mavyret differs across Community Care Health Plan, INC.'s Medicare Part D plans and product strengths — 1 of 2 Mavyret 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.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret]19407091 / 1100Prior authorization required
glecaprevir 50 MG / pibrentasvir 20 MG Oral Pellet [Mavyret]25579100 / 1000Not on formulary

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

Plan-by-plan detail — glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret]

Mavyret has 2 products in the corpus; this table is for glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Community Care's Partnership Program (HMO D-SNP)H2034-0011YesNoNo
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.

Mavyret at other payers

Or see Mavyret 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.