Benefily
No prior authorization

Does Selecthealth, INC. require prior authorization for Breyna?

Selecthealth, INC. 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 productPlans coveringRequire prior authStep therapyQty limitStatus
120 ACTUAT budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna]259767014 / 140014No prior authorization
120 ACTUAT budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler [Breyna]259767314 / 140014No 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.

PlanContractTierPrior authStep therapyQty limit
Select Health Medicare + Kroger (HMO)H1994-0214NoNoYes
Select Health Medicare + Kroger (HMO)H1994-0224NoNoYes
Select Health Medicare + Kroger (HMO)H1994-0304NoNoYes
Select Health Medicare + Kroger (HMO)H1994-0344NoNoYes
Select Health Medicare Active (HMO)H1994-0354NoNoYes
Select Health Medicare Dual (HMO D-SNP)H1994-0154NoNoYes
Select Health Medicare Dual (HMO D-SNP)H1994-0404NoNoYes
Select Health Medicare Essential (HMO)H1994-0014NoNoYes
Select Health Medicare Essential (HMO)H1994-0124NoNoYes
Select Health Medicare Essential (HMO)H1994-0174NoNoYes
Select Health Medicare Essential (HMO)H1994-0274NoNoYes
Select Health Medicare Essential (HMO)H1994-0294NoNoYes
Select Health Medicare Flex (HMO)H1994-0314NoNoYes
Select Health Medicare Wellness (HMO)H1994-0444NoNoYes
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.

Breyna at other payers

Or see Breyna 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.