Benefily
Varies by plan

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

Prior authorization for NovoLog differs across Elevance Health (Anthem)'s Medicare Part D plans and product strengths — 3 of 3 NovoLog 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: 2 of 67 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 productPlans coveringRequire prior authStep therapyQty limitStatus
3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog]165319867 / 67000No prior authorization
3 ML insulin aspart, human 100 UNT/ML Pen Injector [NovoLog]165320467 / 67000No prior authorization
insulin aspart, human 100 UNT/ML Injectable Solution [NovoLog]35192667 / 67200Varies by plan

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

Plan-by-plan detail — 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog]

NovoLog has 3 products in the corpus; this table is for 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Chronic Care (HMO-POS C-SNP)H3447-0373NoNoNo
Anthem Chronic Care (HMO-POS C-SNP)H3447-0563NoNoNo
Anthem Dual Advantage (HMO D-SNP)H0629-0023NoNoNo
Anthem Dual Advantage (HMO D-SNP)H4694-0023NoNoNo
Anthem Dual Advantage (HMO D-SNP)H5854-0203NoNoNo
Anthem Dual Advantage (PPO D-SNP)H2441-0013NoNoNo
Anthem Dual Advantage (PPO D-SNP)H2836-0073NoNoNo
Anthem Extra Help (HMO-POS)H3447-0243NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H0629-0013NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H3447-0183NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H4694-0043NoNoNo
Anthem Full Dual Advantage (PPO D-SNP)H2836-0063NoNoNo
Anthem Full Dual Advantage 2 (HMO D-SNP)H3447-0533NoNoNo
Anthem Full Dual Advantage 2 (HMO D-SNP)H4694-0013NoNoNo
Anthem Full Dual Advantage Select (HMO D-SNP)H5854-0133NoNoNo
Anthem Full Dual Advantage Support (HMO D-SNP)H4694-0033NoNoNo
Anthem HealthPlus Full Dual Advantage (HMO D-SNP)H8432-0423NoNoNo
Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP)H8432-0413NoNoNo
Anthem HealthPlus Full Dual Advantage LTSS 2 (HMO D-SNP)H6988-0043NoNoNo
Anthem I PathWays Dual Care Advantage (HMO D-SNP)H0629-0033NoNoNo
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP)H0629-0043NoNoNo
Anthem Kidney Care (HMO-POS C-SNP)H3447-0333NoNoNo
Anthem Kidney Care (HMO-POS C-SNP)H5854-0123NoNoNo
Anthem Kidney Care (PPO C-SNP)H8552-0283NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0133NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0383NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0383NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0423NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0423NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0423NoNoNo
Anthem Medicare Advantage (HMO-POS)H3447-0423NoNoNo
Anthem Medicare Advantage (HMO-POS)H8432-0403NoNoNo
Anthem Medicare Advantage (HMO)H5854-0193NoNoNo
Anthem Medicare Advantage (HMO)H5854-0193NoNoNo
Anthem Medicare Advantage (HMO)H8432-0093NoNoNo
Anthem Medicare Advantage (HMO)H8432-0103NoNoNo
Anthem Medicare Advantage (HMO)H8432-0113NoNoNo
Anthem Medicare Advantage (PPO)H4036-0263NoNoNo
Anthem Medicare Advantage (PPO)H4036-0363NoNoNo
Anthem Medicare Advantage (PPO)H4909-0143NoNoNo
Anthem Medicare Advantage (Regional PPO)R5941-0143NoNoNo
Anthem Medicare Advantage (Regional PPO)R5941-0163NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H3447-0253NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0063NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0093NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H6988-0103NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H7220-0043NoNoNo
Anthem Medicare Advantage 2 (HMO-POS)H8432-0163NoNoNo
Anthem Medicare Advantage 2 (PPO)H1607-0153NoNoNo
Anthem Medicare Advantage 2 (PPO)H4036-0303NoNoNo
Anthem Medicare Advantage 2 (PPO)H4909-0263NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0493NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0503NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0513NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H3447-0523NoNoNo
Anthem Medicare Advantage 3 (HMO-POS)H6988-0073NoNoNo
Anthem Medicare Advantage 3 (HMO)H7220-0093NoNoNo
Anthem Medicare Advantage 3 (HMO)H7220-0093NoNoNo
Anthem Medicare Advantage 3 (PPO)H1607-0123NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0083NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0253NoNoNo
Anthem Medicare Advantage 3 (PPO)H4036-0343NoNoNo
Anthem Medicare Advantage 4 (HMO-POS)H3447-0393NoNoNo
Anthem Medicare Advantage 4 (HMO)H7220-0103NoNoNo
Anthem Medicare Advantage 4 (PPO)H4036-0173NoNoNo
Blue MedicareRx Premier (PDP)S2893-0033NoNoNo
Blue MedicareRx Value Plus (PDP)S2893-0013NoNoNo
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.

NovoLog at other payers

Or see NovoLog 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.