Varies by plan

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

Prior authorization for Premarin differs across Simply Healthcare Plans, INC.'s Medicare Part D plans and product strengths — 6 of 6 Premarin products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

By product strength

RxNorm product	Plans covering	Require prior auth	Status
estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin]150840	50 / 50	50	Prior authorization required
estrogens, conjugated (USP) 1.25 MG Oral Tablet [Premarin]202301	50 / 50	50	Prior authorization required
estrogens, conjugated (USP) 0.3 MG Oral Tablet [Premarin]208513	50 / 50	50	Prior authorization required
estrogens, conjugated (USP) 0.9 MG Oral Tablet [Premarin]208949	50 / 50	50	Prior authorization required
estrogens, conjugated (USP) 0.45 MG Oral Tablet [Premarin]404550	50 / 50	50	Prior authorization required
estrogens, conjugated (USP) 0.625 MG/ML Vaginal Cream [Premarin]688242	50 / 50	0	No prior authorization

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

Plan-by-plan detail — estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin]

Premarin has 6 products in the corpus; this table is for estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Simply Complete (HMO D-SNP)	H5471-064	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-066	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-072	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-076	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-082	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-084	3	Yes	No	No
Simply Complete (HMO D-SNP)	H5471-111	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-115	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-118	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-121	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-125	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-138	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-140	3	Yes	No	No
Simply Complete Platinum (HMO D-SNP)	H5471-142	3	Yes	No	No
Simply Extra (HMO)	H5471-112	3	Yes	No	No
Simply Extra Platinum (HMO)	H5471-113	3	Yes	No	No
Simply Extra Platinum (HMO)	H5471-117	3	Yes	No	No
Simply Extra Platinum (HMO)	H5471-120	3	Yes	No	No
Simply Extra Platinum (HMO)	H5471-123	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-127	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-128	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-129	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-130	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-131	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-132	3	Yes	No	No
Simply Integrated (HMO D-SNP)	H5471-133	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-134	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-135	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-136	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-137	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-139	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-141	3	Yes	No	No
Simply Integrated Platinum (HMO D-SNP)	H5471-143	3	Yes	No	No
Simply Level (HMO C-SNP)	H5471-069	3	Yes	No	No
Simply Level (HMO C-SNP)	H5471-070	3	Yes	No	No
Simply Level (HMO C-SNP)	H5471-073	3	Yes	No	No
Simply Level (HMO C-SNP)	H5471-075	3	Yes	No	No
Simply Level (HMO C-SNP)	H5471-080	3	Yes	No	No
Simply Level Platinum (HMO C-SNP)	H5471-116	3	Yes	No	No
Simply Level Platinum (HMO C-SNP)	H5471-119	3	Yes	No	No
Simply Level Platinum (HMO C-SNP)	H5471-122	3	Yes	No	No
Simply Level Platinum (HMO C-SNP)	H5471-126	3	Yes	No	No
Simply More (HMO)	H5471-065	3	Yes	No	No
Simply More (HMO)	H5471-071	3	Yes	No	No
Simply More (HMO)	H5471-074	3	Yes	No	No
Simply More (HMO)	H5471-077	3	Yes	No	No
Simply More (HMO)	H5471-078	3	Yes	No	No
Simply More (HMO)	H5471-110	3	Yes	No	No
Simply More Platinum (HMO)	H5471-114	3	Yes	No	No
Simply More Platinum (HMO)	H5471-124	3	Yes	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.

Premarin at other payers

Or see Premarin 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.