Benefily
Prior authorization required

Does Freedom Health, INC. require prior authorization for Intralipid?

Freedom Health, INC. requires prior authorization for Intralipid 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
250 ML soybean oil 200 MG/ML Injection [Intralipid]179970624 / 242400Prior authorization required
soybean oil 300 MG/ML Injectable Suspension [Intralipid]80513124 / 242400Prior authorization required

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

Plan-by-plan detail — 250 ML soybean oil 200 MG/ML Injection [Intralipid]

Intralipid has 2 products in the corpus; this table is for 250 ML soybean oil 200 MG/ML Injection [Intralipid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Freedom Medi-Medi Full (HMO D-SNP)H5427-0872YesNoNo
Freedom Medi-Medi Partial (HMO D-SNP)H5427-0782YesNoNo
Freedom Medicare Plan Rx (HMO)H5427-0592YesNoNo
Freedom Medicare Plan Rx (HMO)H5427-0602YesNoNo
Freedom M�ximo (HMO-POS)H5427-1122YesNoNo
Freedom M�ximo (HMO-POS)H5427-1132YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0882YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0892YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0912YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0932YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0942YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-0962YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1022YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1032YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1052YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1062YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1072YesNoNo
Freedom VIP Care (HMO C-SNP)H5427-0702YesNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-0992YesNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-1082YesNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0722YesNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0822YesNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0772YesNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0832YesNoNo
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.

Intralipid at other payers

Or see Intralipid 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.