Benefily
No prior authorization

Does Ultimate Health Plans, INC. require prior authorization for Bicillin L-A?

Ultimate Health Plans, INC. does not require prior authorization for Bicillin L-A 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
1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]73156616 / 16000No prior authorization
2 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]73156816 / 16000No prior authorization
4 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]73157116 / 16000No prior authorization

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

Plan-by-plan detail — 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A]

Bicillin L-A has 3 products in the corpus; this table is for 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Advantage Care by Ultimate (HMO C-SNP)H2962-0214NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0264NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0294NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0334NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0504NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0514NoNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0524NoNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0234NoNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0254NoNoNo
Advantage Plus by Ultimate (Full) (HMO D-SNP)H2962-0354NoNoNo
Advantage Plus by Ultimate (Partial) (HMO D-SNP)H2962-0364NoNoNo
Premier by Ultimate (HMO)H2962-0014NoNoNo
Premier by Ultimate (HMO)H2962-0284NoNoNo
Premier by Ultimate (HMO)H2962-0454NoNoNo
Premier by Ultimate (HMO)H2962-0464NoNoNo
Premier by Ultimate (HMO)H2962-0474NoNoNo
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.

Bicillin L-A at other payers

Or see Bicillin L-A 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.