Does Healthier New Jersey Insurance Company require prior authorization for Mavyret?
Healthier New Jersey Insurance Company requires prior authorization for Mavyret 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 |
|---|---|---|---|---|---|
| glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret]1940709 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
| glecaprevir 50 MG / pibrentasvir 20 MG Oral Pellet [Mavyret]2557910 | 8 / 8 | 8 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret]
Mavyret has 2 products in the corpus; this table is for glecaprevir 100 MG / pibrentasvir 40 MG Oral Tablet [Mavyret], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Braven Medicare Choice (PPO) | H0885-001 | 5 | Yes | No | No |
| Braven Medicare Choice (PPO) | H0885-003 | 5 | Yes | No | No |
| Braven Medicare Choice (PPO) | H0885-005 | 5 | Yes | No | No |
| Braven Medicare Choice (PPO) | H0885-006 | 5 | Yes | No | No |
| Braven Medicare Choice Plus (PPO) | H0885-007 | 5 | Yes | No | No |
| Braven Medicare Freedom (PPO) | H0885-002 | 5 | Yes | No | No |
| Braven Medicare Freedom (PPO) | H0885-008 | 5 | Yes | No | No |
| Braven Medicare Freedom (PPO) | H0885-009 | 5 | Yes | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Mavyret 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.