Does Mvp Health Plan, INC. require prior authorization for Lupron?
Mvp Health Plan, INC. does not require prior authorization for Lupron on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
- This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]1115259 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron]1115459 | 8 / 8 | 0 | 0 | 0 | No prior authorization |
| 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]1115464 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| 1.5 ML leuprolide acetate 15 MG/ML Prefilled Syringe [Lupron]1115468 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]1115473 | 8 / 8 | 0 | 0 | 0 | No prior authorization |
| 4-Month 1.5 ML leuprolide acetate 20 MG/ML Prefilled Syringe [Lupron]1946522 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]2639669 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]2639743 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]2639750 | 0 / 8 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron]
Lupron has 9 products in the corpus; this table is for 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| MVP DualAccess (HMO D-SNP) | H3305-033 | 5 | No | No | No |
| MVP DualAccess Complete (HMO D-SNP) | H3305-034 | 5 | No | No | No |
| MVP Medicare Complete Wellness with Part D (PPO) | H9615-022 | 5 | No | No | No |
| MVP Medicare Complete Wellness with Part D (PPO) | H9615-023 | 5 | No | No | No |
| MVP Medicare Complete Wellness with Part D (PPO) | H9615-024 | 5 | No | No | No |
| MVP Medicare Preferred Gold with Part D (HMO-POS) | H3305-015 | 5 | No | No | No |
| MVP Medicare Secure Plus with Part D (HMO-POS) | H3305-022 | 5 | No | No | No |
| MVP Medicare WellSelect with Part D (PPO) | H9615-021 | 5 | No | 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.
Lupron 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.