Varies by plan

Does Elevance Health (Anthem) require prior authorization for Lyllana?

Prior authorization for Lyllana differs across Elevance Health (Anthem)'s Medicare Part D plans and product strengths — 5 of 5 Lyllana 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.

Prior authorization requirements differ across this payer's plans: 13 of 15 covering plans require it. Check the specific plan the member is enrolled in — the plan name and contract number are on their insurance card.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]2399892	15 / 67	13	13	Varies by plan
84 HR estradiol 0.00156 MG/HR Transdermal System [Lyllana]2399895	15 / 67	13	13	Varies by plan
84 HR estradiol 0.00208 MG/HR Transdermal System [Lyllana]2399898	15 / 67	13	13	Varies by plan
84 HR estradiol 0.00313 MG/HR Transdermal System [Lyllana]2399901	15 / 67	13	13	Varies by plan
84 HR estradiol 0.00417 MG/HR Transdermal System [Lyllana]2399904	15 / 67	13	13	Varies by plan

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

Plan-by-plan detail — 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]

Lyllana has 5 products in the corpus; this table is for 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Anthem Medicare Advantage (HMO-POS)	H8432-040	2	Yes	No	Yes
Anthem Medicare Advantage (HMO)	H8432-009	2	Yes	No	Yes
Anthem Medicare Advantage (HMO)	H8432-010	2	Yes	No	Yes
Anthem Medicare Advantage (HMO)	H8432-011	2	Yes	No	Yes
Anthem Medicare Advantage 2 (HMO-POS)	H6988-006	2	Yes	No	Yes
Anthem Medicare Advantage 2 (HMO-POS)	H6988-009	2	Yes	No	Yes
Anthem Medicare Advantage 2 (HMO-POS)	H6988-010	2	Yes	No	Yes
Anthem Medicare Advantage 2 (HMO-POS)	H8432-016	2	Yes	No	Yes
Anthem Medicare Advantage 3 (HMO-POS)	H3447-049	2	Yes	No	Yes
Anthem Medicare Advantage 3 (HMO-POS)	H3447-050	2	Yes	No	Yes
Anthem Medicare Advantage 3 (HMO-POS)	H3447-051	2	Yes	No	Yes
Anthem Medicare Advantage 3 (HMO-POS)	H3447-052	2	Yes	No	Yes
Anthem Medicare Advantage 3 (HMO-POS)	H6988-007	2	Yes	No	Yes
Blue MedicareRx Premier (PDP)	S2893-003	3	No	No	No
Blue MedicareRx Value Plus (PDP)	S2893-001	3	No	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.

Lyllana at other payers

Or see Lyllana 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.