Does Preferred Care Partners, INC. require prior authorization for Lupron?
Prior authorization for Lupron differs across Preferred Care Partners, INC.'s Medicare Part D plans and product strengths — 5 of 9 Lupron 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.
- 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 | 35 / 35 | 35 | 0 | 35 | Prior authorization required |
| 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron]1115459 | 35 / 35 | 35 | 0 | 35 | Prior authorization required |
| 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]1115464 | 35 / 35 | 35 | 0 | 35 | Prior authorization required |
| 1.5 ML leuprolide acetate 15 MG/ML Prefilled Syringe [Lupron]1115468 | 35 / 35 | 35 | 0 | 35 | Prior authorization required |
| 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]1115473 | 35 / 35 | 35 | 0 | 35 | Prior authorization required |
| 4-Month 1.5 ML leuprolide acetate 20 MG/ML Prefilled Syringe [Lupron]1946522 | 0 / 35 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]2639669 | 0 / 35 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]2639743 | 0 / 35 | 0 | 0 | 0 | Not on formulary |
| Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]2639750 | 0 / 35 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]
Lupron has 9 products in the corpus; this table is for 1.5 ML leuprolide acetate 30 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 |
|---|---|---|---|---|---|
| AARP Medicare Advantage CareFlex from UHC FL-32 (HMO-POS) | H1045-057 | 5 | Yes | No | Yes |
| AARP Medicare Advantage CareFlex from UHC FL-33 (HMO-POS) | H1045-058 | 5 | Yes | No | Yes |
| AARP Medicare Advantage CareFlex from UHC FL-34 (HMO-POS) | H1045-059 | 5 | Yes | No | Yes |
| AARP Medicare Advantage CareFlex from UHC FL-35 (HMO-POS) | H1045-060 | 5 | Yes | No | Yes |
| AARP Medicare Advantage CareFlex from UHC FL-37 (HMO-POS) | H1045-067 | 5 | Yes | No | Yes |
| AARP Medicare Advantage CareFlex from UHC FL-39 (HMO-POS) | H1045-069 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0005 (HMO-POS) | H1045-026 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0006 (HMO-POS) | H1045-028 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0007 (HMO-POS) | H1045-030 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0008 (HMO-POS) | H1045-031 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0009 (HMO-POS) | H1045-033 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0010 (HMO-POS) | H1045-034 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0011 (HMO-POS) | H1045-041 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0012 (HMO-POS) | H1045-042 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0013 (HMO-POS) | H1045-043 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-0015 (HMO-POS) | H1045-055 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-001P (HMO-POS) | H1045-036 | 5 | Yes | No | Yes |
| AARP Medicare Advantage from UHC FL-003P (HMO-POS) | H1045-045 | 5 | Yes | No | Yes |
| UHC Complete Care FL-14 (HMO-POS C-SNP) | H1045-048 | 5 | Yes | No | Yes |
| UHC Complete Care FL-14 (HMO-POS C-SNP) | H1045-048 | 5 | Yes | No | Yes |
| UHC Complete Care FL-14 (HMO-POS C-SNP) | H1045-048 | 5 | Yes | No | Yes |
| UHC Complete Care FL-14 (HMO-POS C-SNP) | H1045-048 | 5 | Yes | No | Yes |
| UHC Dual Complete FL-D002 (HMO-POS D-SNP) | H1045-039 | 5 | Yes | No | Yes |
| UHC Preferred Complete Care FL-0003 (HMO C-SNP) | H1045-018 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-D001 (HMO D-SNP) | H1045-012 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-D01P (HMO D-SNP) | H1045-038 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-V1 (HMO D-SNP) | H1045-061 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-V2 (HMO D-SNP) | H1045-064 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-Y2 (HMO-POS D-SNP) | H1045-063 | 5 | Yes | No | Yes |
| UHC Preferred Dual Complete FL-Y3 (HMO-POS D-SNP) | H1045-065 | 5 | Yes | No | Yes |
| UHC Preferred Medicare Advantage FL-0001 (HMO) | H1045-001 | 5 | Yes | No | Yes |
| UHC Preferred Medicare Advantage FL-0002 (HMO) | H1045-005 | 5 | Yes | No | Yes |
| UHC Preferred Medicare Advantage FL-002P (HMO) | H1045-037 | 5 | Yes | No | Yes |
| UHC The Villages Medicare Advantage FL-0004 (HMO-POS) | H1045-025 | 5 | Yes | No | Yes |
| UHC The Villages Medicare Advantage FL-004P (HMO-POS) | H1045-056 | 5 | Yes | No | Yes |
- 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.