No prior authorization
Does SCAN Health Plan require prior authorization for Bicillin L-A?
SCAN Health Plan does not require prior authorization for Bicillin L-A 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 |
|---|---|---|---|---|---|
| 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731566 | 74 / 74 | 0 | 0 | 0 | No prior authorization |
| 2 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731568 | 74 / 74 | 0 | 0 | 0 | No prior authorization |
| 4 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]731571 | 74 / 74 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]
Bicillin L-A has 3 products in the corpus; this table is for 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | H5425-092 | 4 | No | No | No |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | H5425-096 | 4 | No | No | No |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | H5425-107 | 4 | No | No | No |
| SCAN Allied (HMO) | H5425-118 | 4 | No | No | No |
| SCAN Allied (HMO) | H5425-123 | 4 | No | No | No |
| SCAN Alta (HMO) | H5425-082 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H0978-002 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H1822-002 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5244-002 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-034 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-070 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-076 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-102 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-104 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-105 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-106 | 4 | No | No | No |
| SCAN Balance (HMO C-SNP) | H5425-129 | 4 | No | No | No |
| SCAN Balance Texas (HMO C-SNP) | H8902-002 | 4 | No | No | No |
| SCAN Classic (HMO) | H0978-001 | 4 | No | No | No |
| SCAN Classic (HMO) | H1822-001 | 4 | No | No | No |
| SCAN Classic (HMO) | H5244-001 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-001 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-005 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-006 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-007 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-008 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-009 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-019 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-069 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-075 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-101 | 4 | No | No | No |
| SCAN Classic (HMO) | H5425-128 | 4 | No | No | No |
| SCAN Classic Texas (HMO) | H8902-010 | 4 | No | No | No |
| SCAN Classic WA (HMO) | H4026-001 | 4 | No | No | No |
| SCAN Compass (HMO) | H5425-124 | 4 | No | No | No |
| SCAN Connections (HMO D-SNP) | H0976-001 | 4 | No | No | No |
| SCAN Connections at Home (HMO D-SNP) | H0976-002 | 4 | No | No | No |
| SCAN Desert Choice (HMO) | H5425-135 | 4 | No | No | No |
| SCAN Embrace (HMO I-SNP) | H5425-086 | 4 | No | No | No |
| SCAN Embrace (HMO I-SNP) | H5425-087 | 4 | No | No | No |
| SCAN Embrace (HMO-POS I-SNP) | H1822-005 | 4 | No | No | No |
| SCAN Embrace (HMO-POS I-SNP) | H5425-091 | 4 | No | No | No |
| SCAN Embrace Together (HMO I-SNP) | H5425-131 | 4 | No | No | No |
| SCAN Embrace Together (HMO-POS I-SNP) | H1822-008 | 4 | No | No | No |
| SCAN Embrace Together (HMO-POS I-SNP) | H5425-132 | 4 | No | No | No |
| SCAN Essential Savings (HMO) | H5425-133 | 4 | No | No | No |
| SCAN Inspired by women for women (HMO) | H5425-100 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H0978-011 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H1822-007 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5244-005 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-108 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-109 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-110 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-119 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-120 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-121 | 4 | No | No | No |
| SCAN MyChoice (HMO) | H5425-130 | 4 | No | No | No |
| SCAN MyChoice Texas (HMO) | H8902-011 | 4 | No | No | No |
| SCAN MyChoice WA (HMO) | H4026-002 | 4 | No | No | No |
| SCAN Prime (HMO) | H5425-065 | 4 | No | No | No |
| SCAN Select (HMO) | H5425-134 | 4 | No | No | No |
| SCAN Strive (HMO C-SNP) | H0978-010 | 4 | No | No | No |
| SCAN Strive (HMO C-SNP) | H1822-006 | 4 | No | No | No |
| SCAN Strive (HMO C-SNP) | H5244-004 | 4 | No | No | No |
| SCAN Strive (HMO C-SNP) | H5425-097 | 4 | No | No | No |
| SCAN Strive (HMO C-SNP) | H5425-098 | 4 | No | No | No |
| SCAN Strive Texas (HMO C-SNP) | H8902-009 | 4 | No | No | No |
| SCAN Venture (HMO) | H5425-084 | 4 | No | No | No |
| SCAN Venture (HMO) | H5425-085 | 4 | No | No | No |
| Sutter Senior Advantage, a SCAN Medicare Plan (HMO) | H5425-125 | 4 | No | No | No |
| Sutter Senior Advantage, a SCAN Medicare Plan (HMO) | H5425-126 | 4 | No | No | No |
| Sutter Senior Advantage, a SCAN Medicare Plan (HMO) | H5425-127 | 4 | No | No | No |
| VillageHealth (HMO-POS C-SNP) | H5943-003 | 4 | No | No | No |
| VillageHealth (HMO-POS C-SNP) | H5943-004 | 4 | No | No | No |
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.
Bicillin L-A 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.