Benefily
No prior authorization

Does Peoples Health, INC. require prior authorization for Trijardy?

Peoples Health, INC. does not require prior authorization for Trijardy on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235928513 / 130013No prior authorization
24 HR empagliflozin 12.5 MG / linagliptin 2.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235929013 / 130013No prior authorization
24 HR empagliflozin 25 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235935313 / 130013No prior authorization
24 HR empagliflozin 5 MG / linagliptin 2.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]235935813 / 130013No prior authorization

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

Plan-by-plan detail — 24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy]

Trijardy has 4 products in the corpus; this table is for 24 HR empagliflozin 10 MG / linagliptin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Trijardy], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Peoples Health Choices (PPO)H4544-0013NoNoYes
Peoples Health Choices 65 (HMO-POS)H1961-0143NoNoYes
Peoples Health Choices 65 (HMO-POS)H1961-0143NoNoYes
Peoples Health Choices 65 (HMO-POS)H1961-0143NoNoYes
Peoples Health Choices 65 (HMO-POS)H1961-0143NoNoYes
Peoples Health Choices Gold (HMO-POS)H1961-0173NoNoYes
Peoples Health Complete Care LA-5 (HMO-POS C-SNP)H1961-0223NoNoYes
Peoples Health Complete Care LA-6 (HMO-POS C-SNP)H1961-0233NoNoYes
Peoples Health Complete Care LA-7 (HMO-POS C-SNP)H1961-0253NoNoYes
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP)H1961-0243NoNoYes
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)H1961-0203NoNoYes
Peoples Health Secure Complete (HMO-POS D-SNP)H1961-0193NoNoYes
Peoples Health Secure Health (HMO-POS D-SNP)H1961-0033NoNoYes
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.

Trijardy at other payers

Or see Trijardy 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.