Does Medica Health Plans require prior authorization for Omnitrope?
Medica Health Plans requires prior authorization for Omnitrope 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 |
|---|---|---|---|---|---|
| somatropin 5 MG/ML Injectable Solution [Omnitrope]645884 | 17 / 17 | 17 | 0 | 0 | Prior authorization required |
| 1.5 ML somatropin 6.67 MG/ML Cartridge [Omnitrope]854302 | 17 / 17 | 17 | 0 | 0 | Prior authorization required |
| 1.5 ML somatropin 3.3 MG/ML Cartridge [Omnitrope]864110 | 17 / 17 | 17 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — somatropin 5 MG/ML Injectable Solution [Omnitrope]
Omnitrope has 3 products in the corpus; this table is for somatropin 5 MG/ML Injectable Solution [Omnitrope], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Medica Advantage Dual (PPO D-SNP) | H8889-016 | 5 | Yes | No | No |
| Medica Advantage Preferred (PPO) | H8889-011 | 5 | Yes | No | No |
| Medica Advantage Preferred (PPO) | H8889-013 | 5 | Yes | No | No |
| Medica Advantage Select (PPO) | H8889-012 | 5 | Yes | No | No |
| Medica Advantage Select (PPO) | H8889-015 | 5 | Yes | No | No |
| Medica Advantage Select (PPO) | H8889-018 | 5 | Yes | No | No |
| Medica Advantage Solution H6154-001 (HMO-POS) | H6154-001 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-001 (PPO) | H8889-001 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-002 (PPO) | H8889-002 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-003 (PPO) | H8889-003 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-004 (PPO) | H8889-004 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-005 (PPO) | H8889-005 | 5 | Yes | No | No |
| Medica Advantage Solution H8889-008 (PPO) | H8889-008 | 5 | Yes | No | No |
| Medica Advantage Value (PPO) | H8889-010 | 5 | Yes | No | No |
| Medica Advantage Value (PPO) | H8889-014 | 5 | Yes | No | No |
| Medica Advantage Value (PPO) | H8889-017 | 5 | Yes | No | No |
| Medica DUAL Solution (HMO D-SNP) | H2458-002 | 5 | Yes | No | No |
- 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.
Omnitrope 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.