Does Health Plan Of Careoregon, INC. require prior authorization for Epclusa?
Prior authorization for Epclusa differs across Health Plan Of Careoregon, INC.'s Medicare Part D plans and product strengths — 3 of 4 Epclusa 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 | Status |
|---|---|---|---|
| sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet [Epclusa]1799218 | 0 / 1 | 0 | Not on formulary |
| sofosbuvir 200 MG / velpatasvir 50 MG Oral Tablet [Epclusa]2288816 | 1 / 1 | 1 | Prior authorization required |
| sofosbuvir 150 MG / velpatasvir 37.5 MG Oral Pellet [Epclusa]2584199 | 1 / 1 | 1 | Prior authorization required |
| sofosbuvir 200 MG / velpatasvir 50 MG Oral Pellet [Epclusa]2584201 | 1 / 1 | 1 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
- 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.