Benefily
Sign inCreate account
No prior authorization

Does Prominence Healthfirst Of Florida INC require prior authorization for Fetzima?

Prominence Healthfirst Of Florida INC does not require prior authorization for Fetzima on the Medicare Part D plans that cover it.

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

  • No prior authorization is filed, but step therapy applies on 5 of 5 covering plans — the plan requires another drug be tried first.

By product strength

RxNorm productPlans coveringRequire prior authStatus
24 HR levomilnacipran 120 MG Extended Release Oral Capsule [Fetzima]14332235 / 50No prior authorization
24 HR levomilnacipran 20 MG Extended Release Oral Capsule [Fetzima]14332295 / 50No prior authorization
24 HR levomilnacipran 40 MG Extended Release Oral Capsule [Fetzima]14332355 / 50No prior authorization
24 HR levomilnacipran 80 MG Extended Release Oral Capsule [Fetzima]14332415 / 50No prior authorization

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

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.

Fetzima at other payers

Or see Fetzima 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.