Benefily
Prior authorization required

Does Optimum Healthcare, INC. require prior authorization for Mekinist?

Optimum Healthcare, INC. requires prior authorization for Mekinist 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
trametinib 0.5 MG Oral Tablet [Mekinist]142511015 / 1515015Prior authorization required
trametinib 2 MG Oral Tablet [Mekinist]142511815 / 1515015Prior authorization required
trametinib 0.05 MG/ML Oral Solution [Mekinist]263256415 / 1515015Prior authorization required

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

Plan-by-plan detail — trametinib 0.5 MG Oral Tablet [Mekinist]

Mekinist has 3 products in the corpus; this table is for trametinib 0.5 MG Oral Tablet [Mekinist], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Optimum Diamond (HMO C-SNP)H5594-0364YesNoYes
Optimum Diamond Rewards (HMO C-SNP)H5594-0284YesNoYes
Optimum Diamond Rewards (HMO C-SNP)H5594-0344YesNoYes
Optimum Diamond Rewards COPD (HMO C-SNP)H5594-0294YesNoYes
Optimum Diamond Rewards COPD (HMO C-SNP)H5594-0354YesNoYes
Optimum Diamond Savings (HMO C-SNP)H5594-0304YesNoYes
Optimum Diamond Savings COPD (HMO C-SNP)H5594-0314YesNoYes
Optimum Emerald Full (HMO D-SNP)H5594-0174YesNoYes
Optimum Emerald Partial (HMO D-SNP)H5594-0164YesNoYes
Optimum Gold Plan (HMO)H5594-0194YesNoYes
Optimum Gold Plus Plan (HMO)H5594-0324YesNoYes
Optimum Gold Rewards Plan (HMO)H5594-0014YesNoYes
Optimum Gold Rewards Plan (HMO)H5594-0224YesNoYes
Optimum Gold Rewards Plan (HMO)H5594-0264YesNoYes
Optimum Platinum Plan (HMO)H5594-0024YesNoYes
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.

Mekinist at other payers

Or see Mekinist 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.