Benefily
Varies by plan

Does Humana require prior authorization for Eligard?

Prior authorization for Eligard differs across Humana's Medicare Part D plans and product strengths — 3 of 4 Eligard 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 productPlans coveringRequire prior authStep therapyQty limitStatus
0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]825325817 / 81781700Prior authorization required
0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]825333817 / 81781700Prior authorization required
0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard]825334817 / 81781700Prior authorization required
0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]8253350 / 817000Not on formulary

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

Plan-by-plan detail — 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]

Eligard has 4 products in the corpus; this table is for 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Humana Basic Rx Plan (PDP)S5884-1014YesNoNo
Humana Basic Rx Plan (PDP)S5884-1024YesNoNo
Humana Basic Rx Plan (PDP)S5884-1034YesNoNo
Humana Basic Rx Plan (PDP)S5884-1044YesNoNo
Humana Basic Rx Plan (PDP)S5884-1054YesNoNo
Humana Basic Rx Plan (PDP)S5884-1064YesNoNo
Humana Basic Rx Plan (PDP)S5884-1074YesNoNo
Humana Basic Rx Plan (PDP)S5884-1084YesNoNo
Humana Basic Rx Plan (PDP)S5884-1094YesNoNo
Humana Basic Rx Plan (PDP)S5884-1104YesNoNo
Humana Basic Rx Plan (PDP)S5884-1114YesNoNo
Humana Basic Rx Plan (PDP)S5884-1124YesNoNo
Humana Basic Rx Plan (PDP)S5884-1134YesNoNo
Humana Basic Rx Plan (PDP)S5884-1144YesNoNo
Humana Basic Rx Plan (PDP)S5884-1154YesNoNo
Humana Basic Rx Plan (PDP)S5884-1164YesNoNo
Humana Basic Rx Plan (PDP)S5884-1314YesNoNo
Humana Basic Rx Plan (PDP)S5884-1324YesNoNo
Humana Basic Rx Plan (PDP)S5884-1334YesNoNo
Humana Basic Rx Plan (PDP)S5884-1344YesNoNo
Humana Basic Rx Plan (PDP)S5884-1354YesNoNo
Humana Basic Rx Plan (PDP)S5884-1364YesNoNo
Humana Basic Rx Plan (PDP)S5884-1374YesNoNo
Humana Basic Rx Plan (PDP)S5884-1384YesNoNo
Humana Basic Rx Plan (PDP)S5884-1394YesNoNo
Humana Basic Rx Plan (PDP)S5884-1404YesNoNo
Humana Basic Rx Plan (PDP)S5884-1414YesNoNo
Humana Basic Rx Plan (PDP)S5884-1424YesNoNo
Humana Basic Rx Plan (PDP)S5884-1434YesNoNo
Humana Basic Rx Plan (PDP)S5884-1444YesNoNo
Humana Basic Rx Plan (PDP)S5884-1454YesNoNo
Humana Basic Rx Plan (PDP)S5884-1464YesNoNo
Humana Basic Rx Plan (PDP)S5884-1474YesNoNo
Humana Basic Rx Plan (PDP)S5884-2164YesNoNo
Humana Cleveland Clinic Preferred (HMO-POS)H6622-0234YesNoNo
Humana Community (HMO-POS)H4623-0024YesNoNo
Humana Community (HMO)H0292-0014YesNoNo
Humana Community (HMO)H1036-2364YesNoNo
Humana Community (HMO)H1036-3324YesNoNo
Humana Community (HMO)H5178-0024YesNoNo
Humana Community (HMO)H5619-1594YesNoNo
Humana Community HMO Diabetes and Heart (HMO C-SNP)H1036-2344YesNoNo
Humana Community HMO Diabetes and Heart (HMO C-SNP)H1468-0174YesNoNo
Humana Community HMO SNP-DE (HMO D-SNP)H1036-2354YesNoNo
Humana Direct Choice Giveback (PPO)H5216-4064YesNoNo
Humana Direct Choice Giveback (PPO)H5216-4244YesNoNo
Humana Direct Choice Giveback (PPO)H5216-4314YesNoNo
Humana Direct Choice Giveback (PPO)H5216-4524YesNoNo
Humana Direct Choice Giveback (PPO)H5970-0314YesNoNo
Humana Direct Choice Giveback (PPO)H7617-1124YesNoNo
Humana Direct Choice GIveback (PPO)H5970-0324YesNoNo
Humana Dual Fully Integrated (HMO D-SNP)H4329-0014YesNoNo
Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)H2875-0014YesNoNo
Humana Dual Fully Integrated H2875-003 (HMO D-SNP)H2875-0034YesNoNo
Humana Dual Integrated (HMO D-SNP)H0963-0014YesNoNo
Humana Dual Integrated (HMO D-SNP)H1036-3394YesNoNo
Humana Dual Integrated (HMO D-SNP)H1036-3404YesNoNo
Humana Dual Integrated (HMO D-SNP)H1036-3414YesNoNo
Humana Dual Integrated (HMO D-SNP)H1396-0014YesNoNo
Humana Dual Select H0028-078 (HMO D-SNP)H0028-0784YesNoNo
Humana Dual Select H0028-079 (HMO D-SNP)H0028-0794YesNoNo
Humana Dual Select H1036-307 (HMO D-SNP)H1036-3074YesNoNo
Humana Dual Select H1036-329 (HMO D-SNP)H1036-3294YesNoNo
Humana Dual Select H1951-056 (HMO D-SNP)H1951-0564YesNoNo
Humana Dual Select H2875-005 (HMO D-SNP)H2875-0054YesNoNo
Humana Dual Select H2875-006 (HMO-POS D-SNP)H2875-0064YesNoNo
Humana Dual Select H4939-002 (HMO-POS D-SNP)H4939-0024YesNoNo
Humana Dual Select H5216-206 (PPO D-SNP)H5216-2064YesNoNo
Humana Dual Select H5216-298 (PPO D-SNP)H5216-2984YesNoNo
Humana Dual Select H5216-361 (PPO D-SNP)H5216-3614YesNoNo
Humana Dual Select H5216-385 (PPO D-SNP)H5216-3854YesNoNo
Humana Dual Select H5525-046 (PPO D-SNP)H5525-0464YesNoNo
Humana Dual Select H5525-072 (PPO D-SNP)H5525-0724YesNoNo
Humana Dual Select H5619-075 (HMO D-SNP)H5619-0754YesNoNo
Humana Dual Select H5619-093 (HMO D-SNP)H5619-0934YesNoNo
Humana Dual Select H5619-126 (HMO-POS D-SNP)H5619-1264YesNoNo
Humana Dual Select H5619-165 (HMO D-SNP)H5619-1654YesNoNo
Humana Dual Select H6622-027 (HMO-POS D-SNP)H6622-0274YesNoNo
Humana Dual Select H7617-039 (PPO D-SNP)H7617-0394YesNoNo
Humana Dual Select H7617-074 (PPO D-SNP)H7617-0744YesNoNo
Humana Dual Select H7617-083 (PPO D-SNP)H7617-0834YesNoNo
Humana Essentials Plus Giveback H0028-063 (HMO)H0028-0634YesNoNo
Humana Essentials Plus Giveback H1036-271 (HMO)H1036-2714YesNoNo
Humana Essentials Plus Giveback H5216-308 (PPO)H5216-3084YesNoNo
Humana Essentials Plus Giveback H5216-358 (PPO)H5216-3584YesNoNo
Humana Essentials Plus Giveback H5216-405 (PPO)H5216-4054YesNoNo
Humana Essentials Plus Giveback H5216-429 (PPO)H5216-4294YesNoNo
Humana Essentials Plus Giveback H5216-430 (PPO)H5216-4304YesNoNo
Humana Essentials Plus Giveback H5216-435 (PPO)H5216-4354YesNoNo
Humana Essentials Plus Giveback H5216-435 (PPO)H5216-4354YesNoNo
Humana Essentials Plus Giveback H5216-435 (PPO)H5216-4354YesNoNo
Humana Essentials Plus Giveback H7617-017 (PPO)H7617-0174YesNoNo
Humana Essentials Plus Giveback H7617-024 (PPO)H7617-0244YesNoNo
Humana Essentials Plus Giveback H7617-035 (PPO)H7617-0354YesNoNo
Humana Essentials Plus Giveback H7617-100 (PPO)H7617-1004YesNoNo
Humana FMOL Baton Rouge H1951-053 (HMO)H1951-0534YesNoNo
Humana Full Access Giveback H5216-306 (PPO)H5216-3064YesNoNo
Humana Full Access Giveback H5216-311 (PPO)H5216-3114YesNoNo
Humana Full Access Giveback H5216-393 (PPO)H5216-3934YesNoNo
Humana Full Access Giveback H7617-058 (PPO)H7617-0584YesNoNo
Showing 100 of 817 covering plans.
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.

Eligard at other payers

Or see Eligard 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.