Benefily
Prior authorization required

Does Medical Mutual Of Ohio require prior authorization for Belsomra?

Medical Mutual Of Ohio requires prior authorization for Belsomra 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 productPlans coveringRequire prior authStep therapyQty limitStatus
suvorexant 10 MG Oral Tablet [Belsomra]154711016 / 1616016Prior authorization required
suvorexant 15 MG Oral Tablet [Belsomra]154711416 / 1616016Prior authorization required
suvorexant 20 MG Oral Tablet [Belsomra]154711816 / 1616016Prior authorization required
suvorexant 5 MG Oral Tablet [Belsomra]154757516 / 1616016Prior authorization required

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

Plan-by-plan detail — suvorexant 10 MG Oral Tablet [Belsomra]

Belsomra has 4 products in the corpus; this table is for suvorexant 10 MG Oral Tablet [Belsomra], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
MedMutual Advantage Access (PPO)H4497-0053YesNoYes
MedMutual Advantage Access (PPO)H4497-0053YesNoYes
MedMutual Advantage Choice (HMO)H6723-0023YesNoYes
MedMutual Advantage Choice (HMO)H6723-0023YesNoYes
MedMutual Advantage Classic (HMO)H6723-0013YesNoYes
MedMutual Advantage Classic (HMO)H6723-0013YesNoYes
MedMutual Advantage Plus (HMO)H6723-0033YesNoYes
MedMutual Advantage Plus (HMO)H6723-0033YesNoYes
MedMutual Advantage Preferred (PPO)H4497-0023YesNoYes
MedMutual Advantage Preferred (PPO)H4497-0023YesNoYes
MedMutual Advantage Premium (PPO)H4497-0033YesNoYes
MedMutual Advantage Premium (PPO)H4497-0033YesNoYes
MedMutual Advantage Select (PPO)H4497-0013YesNoYes
MedMutual Advantage Select (PPO)H4497-0013YesNoYes
MedMutual Advantage Signature (HMO-POS)H6723-0063YesNoYes
MedMutual Advantage Signature (HMO-POS)H6723-0063YesNoYes
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.

Belsomra at other payers

Or see Belsomra 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.