Varies by plan

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

Prior authorization for Procrit differs across Ultimate Health Plans, INC.'s Medicare Part D plans and product strengths — 5 of 6 Procrit products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm product	Plans covering	Require prior auth	Status
1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]1721690	16 / 16	16	Prior authorization required
1 ML epoetin alfa 2000 UNT/ML Injection [Procrit]205918	16 / 16	16	Prior authorization required
1 ML epoetin alfa 3000 UNT/ML Injection [Procrit]205922	16 / 16	16	Prior authorization required
1 ML epoetin alfa 4000 UNT/ML Injection [Procrit]205924	16 / 16	16	Prior authorization required
epoetin alfa 20000 UNT/ML Injectable Solution [Procrit]212219	16 / 16	16	Prior authorization required
1 ML epoetin alfa 40000 UNT/ML Injection [Procrit]213475	0 / 16	0	Not on formulary

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

Plan-by-plan detail — 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]

Procrit has 6 products in the corpus; this table is for 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit], 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	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-026	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-029	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-033	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-050	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-051	4	Yes	No	No
Advantage Care by Ultimate (HMO C-SNP)	H2962-052	4	Yes	No	No
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-023	4	Yes	No	No
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-025	4	Yes	No	No
Advantage Plus by Ultimate (Full) (HMO D-SNP)	H2962-035	4	Yes	No	No
Advantage Plus by Ultimate (Partial) (HMO D-SNP)	H2962-036	4	Yes	No	No
Premier by Ultimate (HMO)	H2962-001	4	Yes	No	No
Premier by Ultimate (HMO)	H2962-028	4	Yes	No	No
Premier by Ultimate (HMO)	H2962-045	4	Yes	No	No
Premier by Ultimate (HMO)	H2962-046	4	Yes	No	No
Premier by Ultimate (HMO)	H2962-047	4	Yes	No	No

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.

Procrit at other payers

Or see Procrit 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.