Benefily
Varies by plan

Does Health Care Service Corporation require prior authorization for Intralipid?

Prior authorization for Intralipid differs across Health Care Service Corporation's Medicare Part D plans and product strengths — 1 of 2 Intralipid 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
250 ML soybean oil 200 MG/ML Injection [Intralipid]179970631 / 313100Prior authorization required
soybean oil 300 MG/ML Injectable Suspension [Intralipid]8051310 / 31000Not on formulary

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

Plan-by-plan detail — 250 ML soybean oil 200 MG/ML Injection [Intralipid]

Intralipid has 2 products in the corpus; this table is for 250 ML soybean oil 200 MG/ML Injection [Intralipid], 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)H8634-0091YesNoNo
Blue Cross Medicare Advantage Balance (PPO)H8634-0314YesNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0014YesNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0024YesNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0124YesNoNo
Blue Cross Medicare Advantage Basic Plus (HMO-POS)H3822-0074YesNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H0107-0054YesNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H8634-0034YesNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H8634-0044YesNoNo
Blue Cross Medicare Advantage Classic (PPO)H0107-0034YesNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0084YesNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0104YesNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0224YesNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0274YesNoNo
Blue Cross Medicare Advantage Complete (PPO)H8634-0234YesNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H0107-0074YesNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0214YesNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0244YesNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0294YesNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H3251-0291YesNoNo
Blue Cross Medicare Advantage Essential (PPO)H8634-0124YesNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H0107-0104YesNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0184YesNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0254YesNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0304YesNoNo
Blue Cross Medicare Advantage Optimum (PPO)H0107-0044YesNoNo
Blue Cross Medicare Advantage Optimum (PPO)H8634-0324YesNoNo
Blue Cross Medicare Advantage Preferred (PPO)H8634-0334YesNoNo
Blue Cross Medicare Advantage Premier Plus (HMO-POS)H3822-0084YesNoNo
Blue Cross Medicare Advantage Select (HMO)H3251-0024YesNoNo
Blue Cross Medicare Advantage Value (HMO)H3822-0144YesNoNo
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.

Intralipid at other payers

Or see Intralipid 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.