Benefily
No prior authorization

Does Healthsun Health Plans, INC. require prior authorization for Glyxambi?

Healthsun Health Plans, INC. does not require prior authorization for Glyxambi on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
empagliflozin 10 MG / linagliptin 5 MG Oral Tablet [Glyxambi]160211513 / 130013No prior authorization
empagliflozin 25 MG / linagliptin 5 MG Oral Tablet [Glyxambi]160212013 / 130013No prior authorization

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — empagliflozin 10 MG / linagliptin 5 MG Oral Tablet [Glyxambi]

Glyxambi has 2 products in the corpus; this table is for empagliflozin 10 MG / linagliptin 5 MG Oral Tablet [Glyxambi], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSun HealthAdvantage Plan (HMO)H5431-0013NoNoYes
HealthSun HealthAdvantage Plan (HMO)H5431-0123NoNoYes
HealthSun HealthAdvantage Plan (HMO)H5431-0133NoNoYes
HealthSun HealthAdvantage Plus (HMO)H5431-0173NoNoYes
HealthSun HealthAdvantage Plus (HMO)H5431-0183NoNoYes
HealthSun HealthAdvantage Plus (HMO)H5431-0203NoNoYes
HealthSun MediMax (HMO)H5431-0063NoNoYes
HealthSun MediSun Extra (HMO D-SNP)H5431-0193NoNoYes
HealthSun MediSun Full Dual Extra (HMO D-SNP)H5431-0263NoNoYes
HealthSun MediSun Full Dual Plus (HMO D-SNP)H5431-0253NoNoYes
HealthSun MediSun Plus (HMO D-SNP)H5431-0163NoNoYes
HealthSun VitalCare (HMO C-SNP)H5431-0213NoNoYes
HealthSun VitalCare (HMO C-SNP)H5431-0223NoNoYes
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
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.

Glyxambi at other payers

Or see Glyxambi across every payer at once.

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.