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Varies by plan

Does Hm Health Insurance Company require prior authorization for Entresto?

Prior authorization for Entresto differs across Hm Health Insurance Company's Medicare Part D plans and product strengths — 5 of 5 Entresto 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.

  • No prior authorization is filed, but step therapy applies on 2 of 2 covering plans — the plan requires another drug be tried first.

By product strength

RxNorm productPlans coveringRequire prior authStatus
sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]16563462 / 20No prior authorization
sacubitril 49 MG / valsartan 51 MG Oral Tablet [Entresto]16563512 / 20No prior authorization
sacubitril 97 MG / valsartan 103 MG Oral Tablet [Entresto]16563562 / 20No prior authorization
sacubitril 15 MG / valsartan 16 MG Oral Pellet [Entresto]26797972 / 22Prior authorization required
sacubitril 6 MG / valsartan 6 MG Oral Pellet [Entresto]26798022 / 22Prior authorization required

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

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.

Entresto at other payers

Or see Entresto 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.