Does Health Partners Plans, INC. require prior authorization for Retevmo?
Prior authorization for Retevmo differs across Health Partners Plans, INC.'s Medicare Part D plans and product strengths — 3 of 4 Retevmo 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| selpercatinib 120 MG Oral Tablet [Retevmo]2679808 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| selpercatinib 160 MG Oral Tablet [Retevmo]2679812 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| selpercatinib 40 MG Oral Tablet [Retevmo]2679814 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| selpercatinib 80 MG Oral Tablet [Retevmo]2679816 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — selpercatinib 120 MG Oral Tablet [Retevmo]
Retevmo has 4 products in the corpus; this table is for selpercatinib 120 MG Oral Tablet [Retevmo], 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
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Retevmo 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.