Benefily
No prior authorization

Does Uhc Of California require prior authorization for Gvoke?

Uhc Of California does not require prior authorization for Gvoke 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
0.1 ML glucagon 5 MG/ML Auto-Injector [Gvoke]219930440 / 40000No prior authorization
0.2 ML glucagon 5 MG/ML Auto-Injector [Gvoke]219930840 / 40000No prior authorization
0.2 ML glucagon 5 MG/ML Prefilled Syringe [Gvoke]219931640 / 40000No prior authorization
0.2 ML glucagon 5 MG/ML Injection [Gvoke]258736140 / 40000No prior authorization

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

Plan-by-plan detail — 0.1 ML glucagon 5 MG/ML Auto-Injector [Gvoke]

Gvoke has 4 products in the corpus; this table is for 0.1 ML glucagon 5 MG/ML Auto-Injector [Gvoke], 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)H0543-0133NoNoNo
AARP Medicare Advantage from UHC CA-0002 (HMO-POS)H0543-0193NoNoNo
AARP Medicare Advantage from UHC CA-0005 (HMO-POS)H0543-0353NoNoNo
AARP Medicare Advantage from UHC CA-0007 (HMO-POS)H0543-0603NoNoNo
AARP Medicare Advantage from UHC CA-0008 (HMO-POS)H0543-0863NoNoNo
AARP Medicare Advantage from UHC CA-0010 (HMO-POS)H0543-1403NoNoNo
AARP Medicare Advantage from UHC CA-0012 (HMO-POS)H0543-1523NoNoNo
AARP Medicare Advantage from UHC CA-0015 (HMO-POS)H0543-1663NoNoNo
AARP Medicare Advantage from UHC CA-003P (HMO-POS)H0543-1513NoNoNo
AARP Medicare Advantage from UHC CA-004P (HMO-POS)H0543-1683NoNoNo
AARP Medicare Advantage from UHC CA-005P (HMO-POS)H0543-1693NoNoNo
AARP Medicare Advantage from UHC CA-006P (HMO-POS)H0543-1703NoNoNo
AARP Medicare Advantage from UHC CA-021P (HMO-POS)H0543-2203NoNoNo
AARP Medicare Advantage from UHC CA-022P (HMO-POS)H0543-2213NoNoNo
AARP Medicare Advantage from UHC CA-023P (HMO-POS)H0543-2223NoNoNo
AARP Medicare Advantage from UHC CA-026P (HMO-POS)H0543-2253NoNoNo
AARP Medicare Advantage from UHC CA-10 (HMO-POS)H0543-1933NoNoNo
AARP Medicare Advantage from UHC CA-33 (HMO-POS)H0543-2323NoNoNo
AARP Medicare Advantage from UHC CA-37 (HMO-POS)H0543-2513NoNoNo
AARP Medicare Advantage from UHC CA-43 (HMO-POS)H0543-2543NoNoNo
AARP Medicare Advantage from UHC CA-44 (HMO-POS)H0543-2553NoNoNo
AARP Medicare Advantage from UHC CA-7 (HMO-POS)H0543-1883NoNoNo
AARP Medicare Advantage from UHC CA-8 (HMO-POS)H0543-1893NoNoNo
AARP Medicare Advantage from UHC CA-9 (HMO-POS)H0543-1913NoNoNo
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS)H0543-2363NoNoNo
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS)H0543-2373NoNoNo
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS)H0543-2383NoNoNo
UHC Complete Care CA-15P (HMO-POS C-SNP)H0543-2143NoNoNo
UHC Complete Care CA-18P (HMO-POS C-SNP)H0543-2173NoNoNo
UHC Complete Care CA-19P (HMO-POS C-SNP)H0543-2183NoNoNo
UHC Complete Care CA-20P (HMO-POS C-SNP)H0543-2193NoNoNo
UHC Complete Care CA-27P (HMO-POS C-SNP)H0543-2263NoNoNo
UHC Complete Care Support CA-1AP (HMO C-SNP)H0543-2393NoNoNo
UHC Complete Care Support CA-2AP (HMO C-SNP)H0543-2403NoNoNo
UHC Complete Care Support CA-3AP (HMO C-SNP)H0543-2413NoNoNo
UHC Complete Care Support CA-4AP (HMO C-SNP)H0543-2423NoNoNo
UHC Complete Care Support CA-6AP (HMO C-SNP)H0543-2463NoNoNo
UHC Complete Care Support CA-8AP (HMO-POS C-SNP)H0543-2493NoNoNo
UHC Sharp Medicare Advantage CA-001P (HMO-POS)H0543-1453NoNoNo
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS)H0543-2043NoNoNo
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.

Gvoke at other payers

Or see Gvoke 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.