Benefily
No prior authorization

Does Simply Healthcare Plans, INC. require prior authorization for Novolin R?

Simply Healthcare Plans, INC. does not require prior authorization for Novolin R 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
3 ML insulin, regular, human 100 UNT/ML Pen Injector [Novolin R]220609250 / 50000No prior authorization
insulin, regular, human 100 UNT/ML Injectable Solution [Novolin R]31103350 / 50000No prior authorization

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

Plan-by-plan detail — 3 ML insulin, regular, human 100 UNT/ML Pen Injector [Novolin R]

Novolin R has 2 products in the corpus; this table is for 3 ML insulin, regular, human 100 UNT/ML Pen Injector [Novolin R], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Simply Complete (HMO D-SNP)H5471-0643NoNoNo
Simply Complete (HMO D-SNP)H5471-0663NoNoNo
Simply Complete (HMO D-SNP)H5471-0723NoNoNo
Simply Complete (HMO D-SNP)H5471-0763NoNoNo
Simply Complete (HMO D-SNP)H5471-0823NoNoNo
Simply Complete (HMO D-SNP)H5471-0843NoNoNo
Simply Complete (HMO D-SNP)H5471-1113NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1153NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1183NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1213NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1253NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1383NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1403NoNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1423NoNoNo
Simply Extra (HMO)H5471-1123NoNoNo
Simply Extra Platinum (HMO)H5471-1133NoNoNo
Simply Extra Platinum (HMO)H5471-1173NoNoNo
Simply Extra Platinum (HMO)H5471-1203NoNoNo
Simply Extra Platinum (HMO)H5471-1233NoNoNo
Simply Integrated (HMO D-SNP)H5471-1273NoNoNo
Simply Integrated (HMO D-SNP)H5471-1283NoNoNo
Simply Integrated (HMO D-SNP)H5471-1293NoNoNo
Simply Integrated (HMO D-SNP)H5471-1303NoNoNo
Simply Integrated (HMO D-SNP)H5471-1313NoNoNo
Simply Integrated (HMO D-SNP)H5471-1323NoNoNo
Simply Integrated (HMO D-SNP)H5471-1333NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1343NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1353NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1363NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1373NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1393NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1413NoNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1433NoNoNo
Simply Level (HMO C-SNP)H5471-0693NoNoNo
Simply Level (HMO C-SNP)H5471-0703NoNoNo
Simply Level (HMO C-SNP)H5471-0733NoNoNo
Simply Level (HMO C-SNP)H5471-0753NoNoNo
Simply Level (HMO C-SNP)H5471-0803NoNoNo
Simply Level Platinum (HMO C-SNP)H5471-1163NoNoNo
Simply Level Platinum (HMO C-SNP)H5471-1193NoNoNo
Simply Level Platinum (HMO C-SNP)H5471-1223NoNoNo
Simply Level Platinum (HMO C-SNP)H5471-1263NoNoNo
Simply More (HMO)H5471-0653NoNoNo
Simply More (HMO)H5471-0713NoNoNo
Simply More (HMO)H5471-0743NoNoNo
Simply More (HMO)H5471-0773NoNoNo
Simply More (HMO)H5471-0783NoNoNo
Simply More (HMO)H5471-1103NoNoNo
Simply More Platinum (HMO)H5471-1143NoNoNo
Simply More Platinum (HMO)H5471-1243NoNoNo
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.

Novolin R at other payers

Or see Novolin R 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.