Does Florida Blue Medicare, INC. require prior authorization for Prevymis?
Prior authorization for Prevymis differs across Florida Blue Medicare, INC.'s Medicare Part D plans and product strengths — 2 of 4 Prevymis 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 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.
- 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| letermovir 240 MG Oral Tablet [Prevymis]1988671 | 15 / 15 | 2 | 0 | 15 | Varies by plan |
| letermovir 480 MG Oral Tablet [Prevymis]1988675 | 15 / 15 | 2 | 0 | 15 | Varies by plan |
| letermovir 20 MG Oral Pellet [Prevymis]2693189 | 0 / 15 | 0 | 0 | 0 | Not on formulary |
| letermovir 120 MG Oral Pellet [Prevymis]2693193 | 0 / 15 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — letermovir 240 MG Oral Tablet [Prevymis]
Prevymis has 4 products in the corpus; this table is for letermovir 240 MG Oral Tablet [Prevymis], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| BlueMedicare Classic (HMO) | H1035-017 | 5 | No | No | Yes |
| BlueMedicare Classic (HMO) | H1035-019 | 5 | No | No | Yes |
| BlueMedicare Classic (HMO) | H1035-020 | 5 | No | No | Yes |
| BlueMedicare Classic (HMO) | H1035-021 | 5 | No | No | Yes |
| BlueMedicare Preferred (HMO) | H1035-052 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-022 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-025 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-026 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-033 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-034 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-043 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-045 | 5 | No | No | Yes |
| BlueMedicare Premier (HMO) | H1035-048 | 5 | No | No | Yes |
| FHCP Medicare Classic (HMO) | H1035-040 | 5 | Yes | No | Yes |
| FHCP Medicare Rx Plus (HMO-POS) | H1035-002 | 5 | Yes | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Prevymis at other payers
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.