Varies by plan

Does Sunshine State Health Plan, INC. require prior authorization for Emgality?

Prior authorization for Emgality differs across Sunshine State Health Plan, INC.'s Medicare Part D plans and product strengths — 2 of 3 Emgality 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.

This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]2058877	24 / 24	24	24	Prior authorization required
1 ML galcanezumab-gnlm 120 MG/ML Prefilled Syringe [Emgality]2058887	24 / 24	24	24	Prior authorization required
1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]2170613	0 / 24	0	0	Not on formulary

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

Plan-by-plan detail — 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality]

Emgality has 3 products in the corpus; this table is for 1 ML galcanezumab-gnlm 120 MG/ML Auto-Injector [Emgality], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Wellcare Dual Access Sync (HMO D-SNP)	H1032-240	3	Yes	No	Yes
Wellcare Dual Access Sync (HMO D-SNP)	H1032-241	3	Yes	No	Yes
Wellcare Dual Access Sync (HMO D-SNP)	H1032-244	3	Yes	No	Yes
Wellcare Dual Access Sync (HMO D-SNP)	H1032-244	3	Yes	No	Yes
Wellcare Dual Reserve (HMO D-SNP)	H1032-202	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-193	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-195	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-198	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-200	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-204	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-210	3	Yes	No	Yes
Wellcare Giveback (HMO)	H1032-212	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-194	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-196	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-199	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-201	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-205	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-211	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-213	3	Yes	No	Yes
Wellcare Simple (HMO)	H1032-237	3	Yes	No	Yes
Wellcare Sunshine Health Dual Align (HMO D-SNP)	H1032-242	3	Yes	No	Yes
Wellcare Sunshine Health Dual Align (HMO D-SNP)	H1032-243	3	Yes	No	Yes
Wellcare Sunshine Health Dual Align (HMO D-SNP)	H1032-245	3	Yes	No	Yes
Wellcare Sunshine Health Dual Align (HMO D-SNP)	H1032-245	3	Yes	No	Yes

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.

Emgality at other payers

Or see Emgality 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.