Benefily
Prior authorization required

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

Freedom Health, INC. requires prior authorization for Orenitram 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
12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]148866724 / 242400Prior authorization required
12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]148867124 / 242400Prior authorization required
12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]148867524 / 242400Prior authorization required
12 HR treprostinil 2.5 MG Extended Release Oral Tablet [Orenitram]148867924 / 242400Prior authorization required
12 HR treprostinil 5 MG Extended Release Oral Tablet [Orenitram]185883324 / 242400Prior authorization required

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

Plan-by-plan detail — 12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]

Orenitram has 5 products in the corpus; this table is for 12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram], 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)H5427-0873YesNoNo
Freedom Medi-Medi Partial (HMO D-SNP)H5427-0783YesNoNo
Freedom Medicare Plan Rx (HMO)H5427-0593YesNoNo
Freedom Medicare Plan Rx (HMO)H5427-0603YesNoNo
Freedom M�ximo (HMO-POS)H5427-1123YesNoNo
Freedom M�ximo (HMO-POS)H5427-1133YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0883YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0893YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0913YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0933YesNoNo
Freedom Platinum Plan Rx (HMO)H5427-0943YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-0963YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1023YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1033YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1053YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1063YesNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1073YesNoNo
Freedom VIP Care (HMO C-SNP)H5427-0703YesNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-0993YesNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-1083YesNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0723YesNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0823YesNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0773YesNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0833YesNoNo
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.

Orenitram at other payers

Or see Orenitram 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.