Benefily
Prior authorization required

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

Tufts Associated Health Maintenance Organization requires prior authorization for Ubrelvy 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
ubrogepant 100 MG Oral Tablet [Ubrelvy]226822721 / 212100Prior authorization required
ubrogepant 50 MG Oral Tablet [Ubrelvy]226823121 / 212100Prior authorization required

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

Plan-by-plan detail — ubrogepant 100 MG Oral Tablet [Ubrelvy]

Ubrelvy has 2 products in the corpus; this table is for ubrogepant 100 MG Oral Tablet [Ubrelvy], 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)H8330-0011YesNoNo
Tufts Health Plan Senior Care Options CW (HMO D-SNP)H8330-0021YesNoNo
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0264YesNoNo
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0264YesNoNo
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0264YesNoNo
Tufts Medicare Preferred HMO Basic Rx (HMO)H2256-0364YesNoNo
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0154YesNoNo
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0154YesNoNo
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0154YesNoNo
Tufts Medicare Preferred HMO Prime Rx (HMO)H2256-0334YesNoNo
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0014YesNoNo
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0014YesNoNo
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)H2256-0014YesNoNo
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)H2256-0464YesNoNo
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0184YesNoNo
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0184YesNoNo
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0184YesNoNo
Tufts Medicare Preferred HMO Value Rx (HMO)H2256-0344YesNoNo
Tufts Medicare Preferred PPO RX (PPO)H9907-0024YesNoNo
Tufts Medicare Preferred PPO RX (PPO)H9907-0024YesNoNo
Tufts Medicare Preferred PPO RX (PPO)H9907-0024YesNoNo
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.

Ubrelvy at other payers

Or see Ubrelvy 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.