Benefily
No prior authorization

Does Tufts Associated Health Maintenance Organization require prior authorization for Trelegy?

Tufts Associated Health Maintenance Organization does not require prior authorization for Trelegy 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
30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / umeclidinium 0.0625 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Trelegy]194504821 / 210021No prior authorization
30 ACTUAT fluticasone furoate 0.2 MG/ACTUAT / umeclidinium 0.0625 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Trelegy]239577521 / 210021No prior authorization

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

Plan-by-plan detail — 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / umeclidinium 0.0625 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Trelegy]

Trelegy has 2 products in the corpus; this table is for 30 ACTUAT fluticasone furoate 0.1 MG/ACTUAT / umeclidinium 0.0625 MG/ACTUAT / vilanterol 0.025 MG/ACTUAT Dry Powder Inhaler [Trelegy], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Tufts Health Plan Senior Care Options (HMO D-SNP)H8330-0011NoNoYes
Tufts Health Plan Senior Care Options CW (HMO D-SNP)H8330-0021NoNoYes
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0263NoNoYes
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0263NoNoYes
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0263NoNoYes
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0363NoNoYes
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0153NoNoYes
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0153NoNoYes
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0153NoNoYes
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0333NoNoYes
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0013NoNoYes
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0013NoNoYes
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0013NoNoYes
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)H2256-0463NoNoYes
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0183NoNoYes
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0183NoNoYes
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0183NoNoYes
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0343NoNoYes
Tufts Medicare Preferred PPO RX (PPO)H9907-0023NoNoYes
Tufts Medicare Preferred PPO RX (PPO)H9907-0023NoNoYes
Tufts Medicare Preferred PPO RX (PPO)H9907-0023NoNoYes
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.

Trelegy at other payers

Or see Trelegy 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.