Benefily
No prior authorization

Does Uhc Of California require prior authorization for Fyavolv?

Uhc Of California does not require prior authorization for Fyavolv 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
ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet [Fyavolv]173665440 / 40000No prior authorization
ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet [Fyavolv]173665640 / 40000No prior authorization

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

Plan-by-plan detail — ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet [Fyavolv]

Fyavolv has 2 products in the corpus; this table is for ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet [Fyavolv], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
AARP Medicare Advantage from UHC CA-0001 (HMO-POS)H0543-0134NoNoNo
AARP Medicare Advantage from UHC CA-0002 (HMO-POS)H0543-0194NoNoNo
AARP Medicare Advantage from UHC CA-0005 (HMO-POS)H0543-0354NoNoNo
AARP Medicare Advantage from UHC CA-0007 (HMO-POS)H0543-0604NoNoNo
AARP Medicare Advantage from UHC CA-0008 (HMO-POS)H0543-0864NoNoNo
AARP Medicare Advantage from UHC CA-0010 (HMO-POS)H0543-1404NoNoNo
AARP Medicare Advantage from UHC CA-0012 (HMO-POS)H0543-1524NoNoNo
AARP Medicare Advantage from UHC CA-0015 (HMO-POS)H0543-1664NoNoNo
AARP Medicare Advantage from UHC CA-003P (HMO-POS)H0543-1514NoNoNo
AARP Medicare Advantage from UHC CA-004P (HMO-POS)H0543-1684NoNoNo
AARP Medicare Advantage from UHC CA-005P (HMO-POS)H0543-1694NoNoNo
AARP Medicare Advantage from UHC CA-006P (HMO-POS)H0543-1704NoNoNo
AARP Medicare Advantage from UHC CA-021P (HMO-POS)H0543-2204NoNoNo
AARP Medicare Advantage from UHC CA-022P (HMO-POS)H0543-2214NoNoNo
AARP Medicare Advantage from UHC CA-023P (HMO-POS)H0543-2224NoNoNo
AARP Medicare Advantage from UHC CA-026P (HMO-POS)H0543-2254NoNoNo
AARP Medicare Advantage from UHC CA-10 (HMO-POS)H0543-1934NoNoNo
AARP Medicare Advantage from UHC CA-33 (HMO-POS)H0543-2324NoNoNo
AARP Medicare Advantage from UHC CA-37 (HMO-POS)H0543-2514NoNoNo
AARP Medicare Advantage from UHC CA-43 (HMO-POS)H0543-2544NoNoNo
AARP Medicare Advantage from UHC CA-44 (HMO-POS)H0543-2554NoNoNo
AARP Medicare Advantage from UHC CA-7 (HMO-POS)H0543-1884NoNoNo
AARP Medicare Advantage from UHC CA-8 (HMO-POS)H0543-1894NoNoNo
AARP Medicare Advantage from UHC CA-9 (HMO-POS)H0543-1914NoNoNo
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS)H0543-2364NoNoNo
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS)H0543-2374NoNoNo
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS)H0543-2384NoNoNo
UHC Complete Care CA-15P (HMO-POS C-SNP)H0543-2144NoNoNo
UHC Complete Care CA-18P (HMO-POS C-SNP)H0543-2174NoNoNo
UHC Complete Care CA-19P (HMO-POS C-SNP)H0543-2184NoNoNo
UHC Complete Care CA-20P (HMO-POS C-SNP)H0543-2194NoNoNo
UHC Complete Care CA-27P (HMO-POS C-SNP)H0543-2264NoNoNo
UHC Complete Care Support CA-1AP (HMO C-SNP)H0543-2394NoNoNo
UHC Complete Care Support CA-2AP (HMO C-SNP)H0543-2404NoNoNo
UHC Complete Care Support CA-3AP (HMO C-SNP)H0543-2414NoNoNo
UHC Complete Care Support CA-4AP (HMO C-SNP)H0543-2424NoNoNo
UHC Complete Care Support CA-6AP (HMO C-SNP)H0543-2464NoNoNo
UHC Complete Care Support CA-8AP (HMO-POS C-SNP)H0543-2494NoNoNo
UHC Sharp Medicare Advantage CA-001P (HMO-POS)H0543-1454NoNoNo
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS)H0543-2044NoNoNo
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.

Fyavolv at other payers

Or see Fyavolv 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.