Does Health Partners Plans, INC. require prior authorization for Tremfya?
Health Partners Plans, INC. requires prior authorization for Tremfya 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 |
|---|---|---|---|---|---|
| 1 ML guselkumab 100 MG/ML Prefilled Syringe [Tremfya]1928689 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
| 1 ML guselkumab 100 MG/ML Auto-Injector [Tremfya]2118741 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
| 2 ML guselkumab 100 MG/ML Auto-Injector [Tremfya]2693095 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
| 2 ML guselkumab 100 MG/ML Prefilled Syringe [Tremfya]2693097 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1 ML guselkumab 100 MG/ML Prefilled Syringe [Tremfya]
Tremfya has 4 products in the corpus; this table is for 1 ML guselkumab 100 MG/ML Prefilled Syringe [Tremfya], 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 | No |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | H9207-016 | 5 | Yes | No | No |
| Jefferson Health Plans Elite (HMO) | H9207-018 | 5 | Yes | No | No |
| Jefferson Health Plans Giveback (HMO) | H9207-015 | 5 | Yes | No | No |
| Jefferson Health Plans Prime (HMO) | H9207-002 | 5 | Yes | No | No |
| Jefferson Health Plans Select (HMO D-SNP) | H9207-017 | 5 | Yes | No | No |
| Jefferson Health Plans Silver (HMO) | H9207-013 | 5 | Yes | No | No |
| Jefferson Health Plans Special (HMO D-SNP) | H9207-004 | 5 | Yes | No | No |
- 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.
Tremfya 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.