Benefily
Varies by plan

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

Prior authorization for Eligard differs across Harmony Health Plan, INC.'s Medicare Part D plans and product strengths — 3 of 4 Eligard 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.

  • 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
0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]82532519 / 191900Prior authorization required
0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]82533319 / 191900Prior authorization required
0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard]82533419 / 191900Prior authorization required
0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]8253350 / 19000Not on formulary

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

Plan-by-plan detail — 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]

Eligard has 4 products in the corpus; this table is for 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare Assist (HMO-POS)H1416-0423YesNoNo
Wellcare Assist (HMO-POS)H1416-0683YesNoNo
Wellcare Assist (HMO-POS)H1416-0833YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1416-0343YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1416-0353YesNoNo
Wellcare Dual Access Harmony (HMO-POS D-SNP)H1416-0333YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H1416-0443YesNoNo
Wellcare Dual Liberty Nurture (HMO-POS D-SNP)H1416-0433YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1416-0813YesNoNo
Wellcare Giveback (HMO-POS)H1416-0653YesNoNo
Wellcare Giveback (HMO-POS)H1416-0793YesNoNo
Wellcare Giveback Dividend (HMO-POS)H1416-0643YesNoNo
Wellcare Low Premium (HMO-POS)H1416-0263YesNoNo
Wellcare Simple (HMO-POS)H1416-0093YesNoNo
Wellcare Simple (HMO-POS)H1416-0713YesNoNo
Wellcare Simple (HMO-POS)H1416-0723YesNoNo
Wellcare Simple (HMO-POS)H1416-0773YesNoNo
Wellcare Simple Preferred (HMO-POS)H1416-0553YesNoNo
Wellcare Simple Value (HMO-POS)H1416-0823YesNoNo
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.

Eligard at other payers

Or see Eligard 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.