Does Prominence Healthfirst Of Texas require prior authorization for Lyllana?
Prominence Healthfirst Of Texas does not require prior authorization for Lyllana 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]2399892 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 84 HR estradiol 0.00156 MG/HR Transdermal System [Lyllana]2399895 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 84 HR estradiol 0.00208 MG/HR Transdermal System [Lyllana]2399898 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 84 HR estradiol 0.00313 MG/HR Transdermal System [Lyllana]2399901 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
| 84 HR estradiol 0.00417 MG/HR Transdermal System [Lyllana]2399904 | 13 / 13 | 0 | 0 | 13 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]
Lyllana has 5 products in the corpus; this table is for 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Prominence Beyond (HMO-POS) | H7680-019 | 2 | No | No | Yes |
| Prominence Beyond (HMO) | H7680-011 | 2 | No | No | Yes |
| Prominence Diabetes and Heart Care Plus (HMO C-SNP) | H7680-016 | 2 | No | No | Yes |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | H7680-015 | 2 | No | No | Yes |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | H7680-020 | 2 | No | No | Yes |
| Prominence Dual (HMO D-SNP) | H7680-007 | 2 | No | No | Yes |
| Prominence Dual (HMO D-SNP) | H7680-017 | 2 | No | No | Yes |
| Prominence Extra Help (HMO) | H7680-009 | 2 | No | No | Yes |
| Prominence Extra Help (HMO) | H7680-018 | 2 | No | No | Yes |
| Prominence Giveback (HMO) | H7680-012 | 2 | No | No | Yes |
| Prominence Giveback (HMO) | H7680-014 | 2 | No | No | Yes |
| Prominence Plus (HMO) | H7680-001 | 2 | No | No | Yes |
| Prominence Plus (HMO) | H7680-002 | 2 | No | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
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Lyllana 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.