Benefily
Prior authorization required

Does Solis Health Plans, INC. require prior authorization for Matulane?

Solis Health Plans, INC. requires prior authorization for Matulane on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
procarbazine 50 MG Oral Capsule [Matulane]20758824 / 242400Prior authorization required

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

Plan-by-plan detail — procarbazine 50 MG Oral Capsule [Matulane]

PlanContractTierPrior authStep therapyQty limit
Solis Balanced Plan (HMO C-SNP)H0982-0275YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0025YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0105YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0125YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0135YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0235YesNoNo
Solis Guardian Plan (HMO D-SNP)H0982-0255YesNoNo
Solis Healthy Living Plan (HMO)H0982-0075YesNoNo
Solis Healthy Living Plan (HMO)H0982-0085YesNoNo
Solis Healthy Living Plan (HMO)H0982-0095YesNoNo
Solis Healthy Living Plan (HMO)H0982-0205YesNoNo
Solis Healthy Living Plan (HMO)H0982-0225YesNoNo
Solis Healthy Living Plan (HMO)H0982-0245YesNoNo
Solis Wellness Giveback Plan (HMO C-SNP)H0982-0285YesNoNo
Solis Wellness Giveback Plan (HMO C-SNP)H0982-0305YesNoNo
Solis Wellness Giveback Plan (HMO C-SNP)H0982-0315YesNoNo
Solis Wellness Giveback Plan (HMO C-SNP)H0982-0325YesNoNo
Solis Wellness Giveback Plan (HMO C-SNP)H0982-0335YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0165YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0175YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0185YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0195YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0215YesNoNo
Solis Wellness Plan (HMO C-SNP)H0982-0265YesNoNo
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.

Matulane at other payers

Or see Matulane 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.