Prior authorization required

Does Ultimate Health Plans, INC. require prior authorization for Nucala?

Ultimate Health Plans, INC. requires prior authorization for Nucala on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
mepolizumab 100 MG Injection [Nucala]1720606	16 / 16	16	16	Prior authorization required
1 ML mepolizumab 100 MG/ML Auto-Injector [Nucala]2170993	16 / 16	16	16	Prior authorization required
1 ML mepolizumab 100 MG/ML Prefilled Syringe [Nucala]2173822	16 / 16	16	16	Prior authorization required
0.4 ML mepolizumab 100 MG/ML Prefilled Syringe [Nucala]2596445	16 / 16	16	16	Prior authorization required

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

Plan-by-plan detail — mepolizumab 100 MG Injection [Nucala]

Nucala has 4 products in the corpus; this table is for mepolizumab 100 MG Injection [Nucala], 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	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-026	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-029	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-033	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-050	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-051	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-052	5	Yes	No	Yes
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-023	5	Yes	No	Yes
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-025	5	Yes	No	Yes
Advantage Plus by Ultimate (Full) (HMO D-SNP)	H2962-035	5	Yes	No	Yes
Advantage Plus by Ultimate (Partial) (HMO D-SNP)	H2962-036	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-001	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-028	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-045	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-046	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-047	5	Yes	No	Yes

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.

Nucala at other payers

Or see Nucala 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.