Does Hawaii Medical Service Association require prior authorization for Mounjaro?
Hawaii Medical Service Association requires prior authorization for Mounjaro 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 0.5 ML tirzepatide 10 MG/ML Auto-Injector [Mounjaro]2601746 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
| 0.5 ML tirzepatide 30 MG/ML Auto-Injector [Mounjaro]2601758 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
| 0.5 ML tirzepatide 5 MG/ML Auto-Injector [Mounjaro]2601764 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
| 0.5 ML tirzepatide 20 MG/ML Auto-Injector [Mounjaro]2601770 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
| 0.5 ML tirzepatide 25 MG/ML Auto-Injector [Mounjaro]2601776 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
| 0.5 ML tirzepatide 15 MG/ML Auto-Injector [Mounjaro]2601785 | 4 / 4 | 4 | 0 | 4 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 0.5 ML tirzepatide 10 MG/ML Auto-Injector [Mounjaro]
Mounjaro has 6 products in the corpus; this table is for 0.5 ML tirzepatide 10 MG/ML Auto-Injector [Mounjaro], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| HMSA Akamai Advantage Complete (PPO) | H3832-009 | 3 | Yes | No | Yes |
| HMSA Akamai Advantage Complete Plus (PPO) | H3832-010 | 3 | Yes | No | Yes |
| HMSA Akamai Advantage Standard (PPO) | H3832-007 | 3 | Yes | No | Yes |
| HMSA Akamai Advantage Standard Plus (PPO) | H3832-008 | 3 | Yes | No | Yes |
- 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.
Mounjaro 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.