Does Humana require prior authorization for Austedo?
Humana requires prior authorization for Austedo 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 |
|---|---|---|---|---|---|
| deutetrabenazine 12 MG Oral Tablet [Austedo]1876916 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| deutetrabenazine 6 MG Oral Tablet [Austedo]1876920 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| deutetrabenazine 9 MG Oral Tablet [Austedo]1876924 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 12 MG Extended Release Oral Tablet [Austedo]2630147 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 24 MG Extended Release Oral Tablet [Austedo]2630153 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 6 MG Extended Release Oral Tablet [Austedo]2630157 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 30 MG Extended Release Oral Tablet [Austedo]2683285 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 36 MG Extended Release Oral Tablet [Austedo]2683291 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 42 MG Extended Release Oral Tablet [Austedo]2683297 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 48 MG Extended Release Oral Tablet [Austedo]2683303 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
| 24 HR deutetrabenazine 18 MG Extended Release Oral Tablet [Austedo]2686156 | 817 / 817 | 817 | 0 | 817 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail โ deutetrabenazine 12 MG Oral Tablet [Austedo]
Austedo has 11 products in the corpus; this table is for deutetrabenazine 12 MG Oral Tablet [Austedo], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | S5884-101 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-102 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-103 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-104 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-105 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-106 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-107 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-108 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-109 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-110 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-111 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-112 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-113 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-114 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-115 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-116 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-131 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-132 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-133 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-134 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-135 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-136 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-137 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-138 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-139 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-140 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-141 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-142 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-143 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-144 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-145 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-146 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-147 | 5 | Yes | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-216 | 5 | Yes | No | Yes |
| Humana Cleveland Clinic Preferred (HMO-POS) | H6622-023 | 5 | Yes | No | Yes |
| Humana Community (HMO-POS) | H4623-002 | 5 | Yes | No | Yes |
| Humana Community (HMO) | H0292-001 | 5 | Yes | No | Yes |
| Humana Community (HMO) | H1036-236 | 5 | Yes | No | Yes |
| Humana Community (HMO) | H1036-332 | 5 | Yes | No | Yes |
| Humana Community (HMO) | H5178-002 | 5 | Yes | No | Yes |
| Humana Community (HMO) | H5619-159 | 5 | Yes | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1036-234 | 5 | Yes | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1468-017 | 5 | Yes | No | Yes |
| Humana Community HMO SNP-DE (HMO D-SNP) | H1036-235 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-406 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-424 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-431 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-452 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5970-031 | 5 | Yes | No | Yes |
| Humana Direct Choice Giveback (PPO) | H7617-112 | 5 | Yes | No | Yes |
| Humana Direct Choice GIveback (PPO) | H5970-032 | 5 | Yes | No | Yes |
| Humana Dual Fully Integrated (HMO D-SNP) | H4329-001 | 5 | Yes | No | Yes |
| Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) | H2875-001 | 5 | Yes | No | Yes |
| Humana Dual Fully Integrated H2875-003 (HMO D-SNP) | H2875-003 | 5 | Yes | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H0963-001 | 5 | Yes | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-339 | 5 | Yes | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-340 | 5 | Yes | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-341 | 5 | Yes | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1396-001 | 5 | Yes | No | Yes |
| Humana Dual Select H0028-078 (HMO D-SNP) | H0028-078 | 5 | Yes | No | Yes |
| Humana Dual Select H0028-079 (HMO D-SNP) | H0028-079 | 5 | Yes | No | Yes |
| Humana Dual Select H1036-307 (HMO D-SNP) | H1036-307 | 5 | Yes | No | Yes |
| Humana Dual Select H1036-329 (HMO D-SNP) | H1036-329 | 5 | Yes | No | Yes |
| Humana Dual Select H1951-056 (HMO D-SNP) | H1951-056 | 5 | Yes | No | Yes |
| Humana Dual Select H2875-005 (HMO D-SNP) | H2875-005 | 5 | Yes | No | Yes |
| Humana Dual Select H2875-006 (HMO-POS D-SNP) | H2875-006 | 5 | Yes | No | Yes |
| Humana Dual Select H4939-002 (HMO-POS D-SNP) | H4939-002 | 5 | Yes | No | Yes |
| Humana Dual Select H5216-206 (PPO D-SNP) | H5216-206 | 5 | Yes | No | Yes |
| Humana Dual Select H5216-298 (PPO D-SNP) | H5216-298 | 5 | Yes | No | Yes |
| Humana Dual Select H5216-361 (PPO D-SNP) | H5216-361 | 5 | Yes | No | Yes |
| Humana Dual Select H5216-385 (PPO D-SNP) | H5216-385 | 5 | Yes | No | Yes |
| Humana Dual Select H5525-046 (PPO D-SNP) | H5525-046 | 5 | Yes | No | Yes |
| Humana Dual Select H5525-072 (PPO D-SNP) | H5525-072 | 5 | Yes | No | Yes |
| Humana Dual Select H5619-075 (HMO D-SNP) | H5619-075 | 5 | Yes | No | Yes |
| Humana Dual Select H5619-093 (HMO D-SNP) | H5619-093 | 5 | Yes | No | Yes |
| Humana Dual Select H5619-126 (HMO-POS D-SNP) | H5619-126 | 5 | Yes | No | Yes |
| Humana Dual Select H5619-165 (HMO D-SNP) | H5619-165 | 5 | Yes | No | Yes |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | H6622-027 | 5 | Yes | No | Yes |
| Humana Dual Select H7617-039 (PPO D-SNP) | H7617-039 | 5 | Yes | No | Yes |
| Humana Dual Select H7617-074 (PPO D-SNP) | H7617-074 | 5 | Yes | No | Yes |
| Humana Dual Select H7617-083 (PPO D-SNP) | H7617-083 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H0028-063 (HMO) | H0028-063 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H1036-271 (HMO) | H1036-271 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-308 (PPO) | H5216-308 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-358 (PPO) | H5216-358 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-405 (PPO) | H5216-405 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-429 (PPO) | H5216-429 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-430 (PPO) | H5216-430 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H7617-017 (PPO) | H7617-017 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H7617-024 (PPO) | H7617-024 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H7617-035 (PPO) | H7617-035 | 5 | Yes | No | Yes |
| Humana Essentials Plus Giveback H7617-100 (PPO) | H7617-100 | 5 | Yes | No | Yes |
| Humana FMOL Baton Rouge H1951-053 (HMO) | H1951-053 | 5 | Yes | No | Yes |
| Humana Full Access Giveback H5216-306 (PPO) | H5216-306 | 5 | Yes | No | Yes |
| Humana Full Access Giveback H5216-311 (PPO) | H5216-311 | 5 | Yes | No | Yes |
| Humana Full Access Giveback H5216-393 (PPO) | H5216-393 | 5 | Yes | No | Yes |
| Humana Full Access Giveback H7617-058 (PPO) | H7617-058 | 5 | Yes | No | Yes |
- 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.
Austedo 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 โ always verify with the payer before rendering service.