Benefily
Prior authorization required

Does Triple S Advantage, INC. require prior authorization for Thalomid?

Triple S Advantage, INC. requires prior authorization for Thalomid 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
thalidomide 50 MG Oral Capsule [Thalomid]21336022 / 222200Prior authorization required
thalidomide 100 MG Oral Capsule [Thalomid]40444922 / 222200Prior authorization required

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

Plan-by-plan detail — thalidomide 50 MG Oral Capsule [Thalomid]

Thalomid has 2 products in the corpus; this table is for thalidomide 50 MG Oral Capsule [Thalomid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Ahorro Plus (HMO)H5774-0475YesNoNo
Ahorro Plus (HMO)H5774-0475YesNoNo
Ahorro Plus (HMO)H5774-0475YesNoNo
Ahorro Plus (HMO)H5774-0475YesNoNo
Ahorro Plus (HMO)H5774-0475YesNoNo
Brillante (HMO-POS)H5774-0315YesNoNo
Contigo Plus (HMO C-SNP)H5774-0225YesNoNo
ContigoEnMente (HMO C-SNP)H5774-0465YesNoNo
Enlace Plus (HMO)H5774-0385YesNoNo
PLATINO ADVANCE (HMO D-SNP)H5774-0411YesNoNo
PLATINO ADVANCE (HMO D-SNP)H5774-0411YesNoNo
PLATINO ADVANCE (HMO D-SNP)H5774-0411YesNoNo
PLATINO ADVANCE (HMO D-SNP)H5774-0411YesNoNo
PLATINO ADVANCE (HMO D-SNP)H5774-0411YesNoNo
Platino Blindao (HMO D-SNP)H5774-0281YesNoNo
Platino Enlace (HMO D-SNP)H5774-0351YesNoNo
PLATINO PLUS (HMO D-SNP)H5774-0431YesNoNo
PLATINO PLUS (HMO D-SNP)H5774-0431YesNoNo
PLATINO PLUS (HMO D-SNP)H5774-0431YesNoNo
PLATINO PLUS (HMO D-SNP)H5774-0431YesNoNo
PLATINO PLUS (HMO D-SNP)H5774-0431YesNoNo
�ptimo Plus (PPO)H4005-0045YesNoNo
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.

Thalomid at other payers

Or see Thalomid 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.