Benefily
No prior authorization

Does Keystone Health Plan East, INC. require prior authorization for Zubsolv?

Keystone Health Plan East, INC. does not require prior authorization for Zubsolv 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
buprenorphine 1.4 MG / naloxone 0.36 MG Sublingual Tablet [Zubsolv]14310838 / 8000No prior authorization
buprenorphine 5.7 MG / naloxone 1.4 MG Sublingual Tablet [Zubsolv]14311048 / 8000No prior authorization
buprenorphine 11.4 MG / naloxone 2.9 MG Sublingual Tablet [Zubsolv]15975708 / 8000No prior authorization
buprenorphine 8.6 MG / naloxone 2.1 MG Sublingual Tablet [Zubsolv]15975758 / 8000No prior authorization
buprenorphine 2.9 MG / naloxone 0.71 MG Sublingual Tablet [Zubsolv]16663858 / 8000No prior authorization
buprenorphine 0.7 MG / naloxone 0.18 MG Sublingual Tablet [Zubsolv]18644148 / 8000No prior authorization

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

Plan-by-plan detail — buprenorphine 1.4 MG / naloxone 0.36 MG Sublingual Tablet [Zubsolv]

Zubsolv has 6 products in the corpus; this table is for buprenorphine 1.4 MG / naloxone 0.36 MG Sublingual Tablet [Zubsolv], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Keystone 65 Basic Rx (HMO)H3952-0554NoNoNo
Keystone 65 Essential Rx (HMO-POS)H3952-0604NoNoNo
Keystone 65 Focus Rx (HMO-POS)H3952-0534NoNoNo
Keystone 65 Focus Rx (HMO-POS)H3952-0544NoNoNo
Keystone 65 Preferred Rx (HMO)H3952-0204NoNoNo
Keystone 65 Preferred Rx (HMO)H3952-0454NoNoNo
Keystone 65 Select Rx (HMO)H3952-0494NoNoNo
Keystone 65 Select Rx (HMO)H3952-0514NoNoNo
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.

Zubsolv at other payers

Or see Zubsolv 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.