Prior authorization required
Does Medco Containment Life And Medco Containment Ny require prior authorization for Inqovi 5 Tablet Pack?
Medco Containment Life And Medco Containment Ny requires prior authorization for Inqovi 5 Tablet Pack 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 |
|---|---|---|---|---|---|
| {5 (cedazuridine 100 MG / decitabine 35 MG Oral Tablet [Inqovi]) } Pack [Inqovi 5 Tablet Pack]2384465 | 60 / 60 | 60 | 0 | 60 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — {5 (cedazuridine 100 MG / decitabine 35 MG Oral Tablet [Inqovi]) } Pack [Inqovi 5 Tablet Pack]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | S5617-003 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-008 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-013 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-018 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-068 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-088 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-103 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-108 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-113 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-118 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-123 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-128 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-133 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-138 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-143 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-148 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-153 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-158 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-214 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-215 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-216 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-217 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-218 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-219 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-220 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-221 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-222 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-223 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-224 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-225 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-226 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-227 | 5 | Yes | No | Yes |
| HealthSpring Assurance Rx (PDP) | S5617-348 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-353 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-354 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-355 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-356 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-358 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-359 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-360 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-362 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-363 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-364 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-365 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-366 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-367 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-368 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-369 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-370 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-371 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-372 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-373 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-375 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-377 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-378 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-379 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-380 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-381 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-382 | 5 | Yes | No | Yes |
| HealthSpring Extra Rx (PDP) | S5617-385 | 5 | Yes | No | Yes |
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.
Inqovi 5 Tablet Pack 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 — always verify with the payer before rendering service.