Does Mount Carmel Health Plan, INC. require prior authorization for NovoLog?
Prior authorization for NovoLog differs across Mount Carmel Health Plan, INC.'s Medicare Part D plans and product strengths — 3 of 3 NovoLog 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.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog]1653198 | 11 / 11 | 0 | 0 | 0 | No prior authorization |
| 3 ML insulin aspart, human 100 UNT/ML Pen Injector [NovoLog]1653204 | 11 / 11 | 0 | 0 | 0 | No prior authorization |
| insulin aspart, human 100 UNT/ML Injectable Solution [NovoLog]351926 | 11 / 11 | 11 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog]
NovoLog has 3 products in the corpus; this table is for 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| MercyOne Health Plan Cash Back (HMO) | H3668-031 | 3 | No | No | No |
| MercyOne Health Plan No Premium (HMO) | H3668-025 | 3 | No | No | No |
| MercyOne Health Plan Plus (HMO) | H3668-026 | 3 | No | No | No |
| Mount Carmel MediGold Cash Back (HMO) | H3668-030 | 3 | No | No | No |
| Mount Carmel MediGold No Premium (HMO) | H3668-019 | 3 | No | No | No |
| Mount Carmel MediGold No Premium (HMO) | H3668-019 | 3 | No | No | No |
| Mount Carmel MediGold No Premium (HMO) | H3668-020 | 3 | No | No | No |
| Mount Carmel MediGold Plus (HMO) | H3668-022 | 3 | No | No | No |
| Mount Carmel MediGold Plus (HMO) | H3668-023 | 3 | No | No | No |
| Mount Carmel MediGold Premier (HMO) | H3668-018 | 3 | No | No | No |
| Mount Carmel MediGold Premier (HMO) | H3668-018 | 3 | No | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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NovoLog 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.