Does Ultimate Health Plans, INC. require prior authorization for Janumet?
Ultimate Health Plans, INC. does not require prior authorization for Janumet 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 24 HR metformin hydrochloride 1000 MG / sitagliptin phosphate 100 MG Extended Release Oral Tablet [Janumet]1243833 | 16 / 16 | 0 | 0 | 0 | No prior authorization |
| 24 HR metformin hydrochloride 1000 MG / sitagliptin phosphate 50 MG Extended Release Oral Tablet [Janumet]1243843 | 16 / 16 | 0 | 0 | 0 | No prior authorization |
| 24 HR metformin hydrochloride 500 MG / sitagliptin phosphate 50 MG Extended Release Oral Tablet [Janumet]1243848 | 16 / 16 | 0 | 0 | 0 | No prior authorization |
| metformin hydrochloride 1000 MG / sitagliptin phosphate 50 MG Oral Tablet [Janumet]861771 | 16 / 16 | 0 | 0 | 0 | No prior authorization |
| metformin hydrochloride 500 MG / sitagliptin phosphate 50 MG Oral Tablet [Janumet]861821 | 16 / 16 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 24 HR metformin hydrochloride 1000 MG / sitagliptin phosphate 100 MG Extended Release Oral Tablet [Janumet]
Janumet has 5 products in the corpus; this table is for 24 HR metformin hydrochloride 1000 MG / sitagliptin phosphate 100 MG Extended Release Oral Tablet [Janumet], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Advantage Care by Ultimate (HMO C-SNP) | H2962-021 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-026 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-029 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-033 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-050 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-051 | 6 | No | No | No |
| Advantage Care by Ultimate (HMO C-SNP) | H2962-052 | 6 | No | No | No |
| Advantage Care COPD by Ultimate (HMO C-SNP) | H2962-023 | 6 | No | No | No |
| Advantage Care COPD by Ultimate (HMO C-SNP) | H2962-025 | 6 | No | No | No |
| Advantage Plus by Ultimate (Full) (HMO D-SNP) | H2962-035 | 3 | No | No | No |
| Advantage Plus by Ultimate (Partial) (HMO D-SNP) | H2962-036 | 3 | No | No | No |
| Premier by Ultimate (HMO) | H2962-001 | 3 | No | No | No |
| Premier by Ultimate (HMO) | H2962-028 | 3 | No | No | No |
| Premier by Ultimate (HMO) | H2962-045 | 3 | No | No | No |
| Premier by Ultimate (HMO) | H2962-046 | 3 | No | No | No |
| Premier by Ultimate (HMO) | H2962-047 | 3 | No | No | No |
- 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.
Janumet 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.