Benefily
No prior authorization

Does Harmony Health Plan, INC. require prior authorization for Drizalma?

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

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

  • 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 productPlans coveringRequire prior authStep therapyQty limitStatus
Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma]220017419 / 190019No prior authorization
Sprinkle duloxetine 30 MG Delayed Release Oral Capsule [Drizalma]220017719 / 190019No prior authorization
Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma]220018019 / 190019No prior authorization
Sprinkle duloxetine 60 MG Delayed Release Oral Capsule [Drizalma]22001830 / 19000Not on formulary

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

Plan-by-plan detail — Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma]

Drizalma has 4 products in the corpus; this table is for Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare Assist (HMO-POS)H1416-0424NoNoYes
Wellcare Assist (HMO-POS)H1416-0684NoNoYes
Wellcare Assist (HMO-POS)H1416-0834NoNoYes
Wellcare Dual Access (HMO-POS D-SNP)H1416-0344NoNoYes
Wellcare Dual Access (HMO-POS D-SNP)H1416-0354NoNoYes
Wellcare Dual Access Harmony (HMO-POS D-SNP)H1416-0334NoNoYes
Wellcare Dual Liberty (HMO-POS D-SNP)H1416-0444NoNoYes
Wellcare Dual Liberty Nurture (HMO-POS D-SNP)H1416-0434NoNoYes
Wellcare Dual Reserve (HMO-POS D-SNP)H1416-0814NoNoYes
Wellcare Giveback (HMO-POS)H1416-0654NoNoYes
Wellcare Giveback (HMO-POS)H1416-0794NoNoYes
Wellcare Giveback Dividend (HMO-POS)H1416-0644NoNoYes
Wellcare Low Premium (HMO-POS)H1416-0264NoNoYes
Wellcare Simple (HMO-POS)H1416-0094NoNoYes
Wellcare Simple (HMO-POS)H1416-0714NoNoYes
Wellcare Simple (HMO-POS)H1416-0724NoNoYes
Wellcare Simple (HMO-POS)H1416-0774NoNoYes
Wellcare Simple Preferred (HMO-POS)H1416-0554NoNoYes
Wellcare Simple Value (HMO-POS)H1416-0824NoNoYes
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.

Drizalma at other payers

Or see Drizalma 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.