Does Providence Health Assurance require prior authorization for Breyna?
Providence Health Assurance does not require prior authorization for Breyna 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 |
|---|---|---|---|---|---|
| 120 ACTUAT budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna]2597670 | 7 / 7 | 0 | 0 | 7 | No prior authorization |
| 120 ACTUAT budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna]2597673 | 7 / 7 | 0 | 0 | 7 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 120 ACTUAT budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna]
Breyna has 2 products in the corpus; this table is for 120 ACTUAT budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Providence Medicare Dual Plus (HMO D-SNP) | H9047-043 | 2 | No | No | Yes |
| Providence Medicare Extra + Rx (HMO) | H9047-064 | 2 | No | No | Yes |
| Providence Medicare Extra Part B Only + Rx (HMO) | H9047-013 | 2 | No | No | Yes |
| Providence Medicare Pine + Rx (HMO) | H9047-063 | 2 | No | No | Yes |
| Providence Medicare Prime + Rx (HMO) | H9047-037 | 2 | No | No | Yes |
| Providence Medicare Sycamore + Rx (HMO) | H9047-066 | 2 | No | No | Yes |
| Providence Medicare Timber + Rx (HMO) | H9047-054 | 2 | No | 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.
Breyna 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.