Does Health Partners Plans, INC. require prior authorization for Epclusa?
Health Partners Plans, INC. requires prior authorization for Epclusa 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 |
|---|---|---|---|---|---|
| sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet [Epclusa]1799218 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| sofosbuvir 200 MG / velpatasvir 50 MG Oral Tablet [Epclusa]2288816 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| sofosbuvir 150 MG / velpatasvir 37.5 MG Oral Pellet [Epclusa]2584199 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| sofosbuvir 200 MG / velpatasvir 50 MG Oral Pellet [Epclusa]2584201 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet [Epclusa]
Epclusa has 4 products in the corpus; this table is for sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet [Epclusa], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Jefferson Health Plans Complete (HMO) | H9207-012 | 5 | Yes | No | Yes |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | H9207-016 | 5 | Yes | No | Yes |
| Jefferson Health Plans Elite (HMO) | H9207-018 | 5 | Yes | No | Yes |
| Jefferson Health Plans Giveback (HMO) | H9207-015 | 5 | Yes | No | Yes |
| Jefferson Health Plans Prime (HMO) | H9207-002 | 5 | Yes | No | Yes |
| Jefferson Health Plans Select (HMO D-SNP) | H9207-017 | 5 | Yes | No | Yes |
| Jefferson Health Plans Silver (HMO) | H9207-013 | 5 | Yes | No | Yes |
| Jefferson Health Plans Special (HMO D-SNP) | H9207-004 | 5 | 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.
Epclusa 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.