Benefily
Prior authorization required

Does Florida Blue Medicare, INC. require prior authorization for Besremi?

Florida Blue Medicare, INC. requires prior authorization for Besremi 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
1 ML ropeginterferon alfa-2b-njft 0.5 MG/ML Prefilled Syringe [Besremi]258707015 / 1515015Prior authorization required

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

Plan-by-plan detail — 1 ML ropeginterferon alfa-2b-njft 0.5 MG/ML Prefilled Syringe [Besremi]

PlanContractTierPrior authStep therapyQty limit
BlueMedicare Classic (HMO)H1035-0175YesNoYes
BlueMedicare Classic (HMO)H1035-0195YesNoYes
BlueMedicare Classic (HMO)H1035-0205YesNoYes
BlueMedicare Classic (HMO)H1035-0215YesNoYes
BlueMedicare Preferred (HMO)H1035-0525YesNoYes
BlueMedicare Premier (HMO)H1035-0225YesNoYes
BlueMedicare Premier (HMO)H1035-0255YesNoYes
BlueMedicare Premier (HMO)H1035-0265YesNoYes
BlueMedicare Premier (HMO)H1035-0335YesNoYes
BlueMedicare Premier (HMO)H1035-0345YesNoYes
BlueMedicare Premier (HMO)H1035-0435YesNoYes
BlueMedicare Premier (HMO)H1035-0455YesNoYes
BlueMedicare Premier (HMO)H1035-0485YesNoYes
FHCP Medicare Classic (HMO)H1035-0405YesNoYes
FHCP Medicare Rx Plus (HMO-POS)H1035-0025YesNoYes
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.

Besremi at other payers

Or see Besremi 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.