Does Uhc Of California require prior authorization for Drizalma?
Uhc Of California does not require prior authorization for Drizalma on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
- No prior authorization is filed, but step therapy applies on 40 of 40 covering plans — the plan requires another drug be tried first.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma]2200174 | 40 / 40 | 0 | 40 | 40 | No prior authorization |
| Sprinkle duloxetine 30 MG Delayed Release Oral Capsule [Drizalma]2200177 | 40 / 40 | 0 | 40 | 40 | No prior authorization |
| Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma]2200180 | 40 / 40 | 0 | 40 | 40 | No prior authorization |
| Sprinkle duloxetine 60 MG Delayed Release Oral Capsule [Drizalma]2200183 | 40 / 40 | 0 | 40 | 40 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma]
Drizalma has 4 products in the corpus; this table is for Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC CA-0001 (HMO-POS) | H0543-013 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | H0543-019 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0005 (HMO-POS) | H0543-035 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0007 (HMO-POS) | H0543-060 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0008 (HMO-POS) | H0543-086 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0010 (HMO-POS) | H0543-140 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0012 (HMO-POS) | H0543-152 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-0015 (HMO-POS) | H0543-166 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | H0543-151 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-004P (HMO-POS) | H0543-168 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-005P (HMO-POS) | H0543-169 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-006P (HMO-POS) | H0543-170 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-021P (HMO-POS) | H0543-220 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-022P (HMO-POS) | H0543-221 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-023P (HMO-POS) | H0543-222 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-026P (HMO-POS) | H0543-225 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-10 (HMO-POS) | H0543-193 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-33 (HMO-POS) | H0543-232 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-37 (HMO-POS) | H0543-251 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-43 (HMO-POS) | H0543-254 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-44 (HMO-POS) | H0543-255 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-7 (HMO-POS) | H0543-188 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-8 (HMO-POS) | H0543-189 | 4 | No | Yes | Yes |
| AARP Medicare Advantage from UHC CA-9 (HMO-POS) | H0543-191 | 4 | No | Yes | Yes |
| AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) | H0543-236 | 4 | No | Yes | Yes |
| AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) | H0543-237 | 4 | No | Yes | Yes |
| AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) | H0543-238 | 4 | No | Yes | Yes |
| UHC Complete Care CA-15P (HMO-POS C-SNP) | H0543-214 | 4 | No | Yes | Yes |
| UHC Complete Care CA-18P (HMO-POS C-SNP) | H0543-217 | 4 | No | Yes | Yes |
| UHC Complete Care CA-19P (HMO-POS C-SNP) | H0543-218 | 4 | No | Yes | Yes |
| UHC Complete Care CA-20P (HMO-POS C-SNP) | H0543-219 | 4 | No | Yes | Yes |
| UHC Complete Care CA-27P (HMO-POS C-SNP) | H0543-226 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-1AP (HMO C-SNP) | H0543-239 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-2AP (HMO C-SNP) | H0543-240 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-3AP (HMO C-SNP) | H0543-241 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-4AP (HMO C-SNP) | H0543-242 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-6AP (HMO C-SNP) | H0543-246 | 4 | No | Yes | Yes |
| UHC Complete Care Support CA-8AP (HMO-POS C-SNP) | H0543-249 | 4 | No | Yes | Yes |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | H0543-145 | 4 | No | Yes | Yes |
| UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) | H0543-204 | 4 | No | Yes | Yes |
- 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.
Drizalma at other payers
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.