Benefily
No prior authorization

Does Health Alliance Plan Of Michigan require prior authorization for Nicotrol?

Health Alliance Plan Of Michigan does not require prior authorization for Nicotrol on the Medicare Part D plans that cover it.

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

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol]17978887 / 7000No prior authorization

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

Plan-by-plan detail — nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol]

PlanContractTierPrior authStep therapyQty limit
HAP Medicare Complete Duals (HMO D-SNP)H2354-0254NoNoNo
HAP Medicare Connect (HMO)H2354-0154NoNoNo
HAP Medicare Diabetes and Heart (HMO C-SNP)H2354-0304NoNoNo
HAP Medicare Superior (HMO)H2354-0284NoNoNo
HAP Senior Plus (HMO-POS)H2354-0214NoNoNo
HAP Senior Plus Henry Ford Tiered Access (HMO)H2354-0184NoNoNo
Henry Ford Select (HMO)H2354-0294NoNoNo
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.

Nicotrol at other payers

Or see Nicotrol 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.