Benefily
No prior authorization

Does Excellus Health Plan, INC. require prior authorization for Edarbyclor?

Excellus Health Plan, INC. does not require prior authorization for Edarbyclor on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • No prior authorization is filed, but step therapy applies on 16 of 16 covering plans — the plan requires another drug be tried first.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
azilsartan medoxomil 40 MG / chlorthalidone 12.5 MG Oral Tablet [Edarbyclor]123515016 / 1601616No prior authorization
azilsartan medoxomil 40 MG / chlorthalidone 25 MG Oral Tablet [Edarbyclor]123515716 / 1601616No prior authorization

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

Plan-by-plan detail — azilsartan medoxomil 40 MG / chlorthalidone 12.5 MG Oral Tablet [Edarbyclor]

Edarbyclor has 2 products in the corpus; this table is for azilsartan medoxomil 40 MG / chlorthalidone 12.5 MG Oral Tablet [Edarbyclor], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Medicare Blue Choice Core (HMO)H3351-0224NoYesYes
Medicare Blue Choice Optimum (HMO-POS)H3351-0064NoYesYes
Medicare Blue Choice Prime (HMO)H3351-0234NoYesYes
Medicare BlueActive (PPO)H3335-0554NoYesYes
Medicare BlueBalanced (PPO)H3335-0624NoYesYes
Medicare BlueClassic (PPO)H3335-0384NoYesYes
Medicare BlueEnhanced (PPO)H3335-0154NoYesYes
Medicare BlueEssential (PPO)H3335-0534NoYesYes
Medicare BluePlus (PPO)H3335-0184NoYesYes
Medicare BlueVital (PPO)H3335-0614NoYesYes
Univera SeniorChoice Advanced (HMO-POS)H3351-0194NoYesYes
Univera SeniorChoice Basic (HMO)H3351-0174NoYesYes
Univera SeniorChoice Core (PPO)H3335-0604NoYesYes
Univera SeniorChoice Extra (HMO)H3351-0204NoYesYes
Univera SeniorChoice Secure (HMO-POS)H3351-0024NoYesYes
Univera SeniorChoice Value Plus (HMO-POS)H3351-0124NoYesYes
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.

Edarbyclor at other payers

Or see Edarbyclor 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.