Benefily
No prior authorization

Does Health Care Service Corporation require prior authorization for Humalog Mix?

Health Care Service Corporation does not require prior authorization for Humalog Mix 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
insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Injectable Suspension [Humalog Mix]75238831 / 310031No prior authorization
3 ML insulin lispro 50 UNT/ML / insulin lispro protamine, human 50 UNT/ML Pen Injector [Humalog Mix]84721331 / 310031No prior authorization
3 ML insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Pen Injector [Humalog Mix]84725431 / 310031No prior authorization

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

Plan-by-plan detail — insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Injectable Suspension [Humalog Mix]

Humalog Mix has 3 products in the corpus; this table is for insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Injectable Suspension [Humalog Mix], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP)H8634-0091NoNoYes
Blue Cross Medicare Advantage Balance (PPO)H8634-0313NoNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0013NoNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0023NoNoYes
Blue Cross Medicare Advantage Basic (HMO)H3822-0123NoNoYes
Blue Cross Medicare Advantage Basic Plus (HMO-POS)H3822-0073NoNoYes
Blue Cross Medicare Advantage Choice Plus (PPO)H0107-0053NoNoYes
Blue Cross Medicare Advantage Choice Plus (PPO)H8634-0033NoNoYes
Blue Cross Medicare Advantage Choice Premier (PPO)H8634-0043NoNoYes
Blue Cross Medicare Advantage Classic (PPO)H0107-0033NoNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0083NoNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0103NoNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0223NoNoYes
Blue Cross Medicare Advantage Classic (PPO)H8634-0273NoNoYes
Blue Cross Medicare Advantage Complete (PPO)H8634-0233NoNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H0107-0073NoNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0213NoNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0243NoNoYes
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0293NoNoYes
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H3251-0291NoNoYes
Blue Cross Medicare Advantage Essential (PPO)H8634-0123NoNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H0107-0103NoNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0183NoNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0253NoNoYes
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0303NoNoYes
Blue Cross Medicare Advantage Optimum (PPO)H0107-0043NoNoYes
Blue Cross Medicare Advantage Optimum (PPO)H8634-0323NoNoYes
Blue Cross Medicare Advantage Preferred (PPO)H8634-0333NoNoYes
Blue Cross Medicare Advantage Premier Plus (HMO-POS)H3822-0083NoNoYes
Blue Cross Medicare Advantage Select (HMO)H3251-0023NoNoYes
Blue Cross Medicare Advantage Value (HMO)H3822-0143NoNoYes
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.

Humalog Mix at other payers

Or see Humalog Mix 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.