Benefily
No prior authorization

Does Wellpoint Texas, INC. require prior authorization for Liomny?

Wellpoint Texas, INC. does not require prior authorization for Liomny 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
liothyronine sodium 0.025 MG Oral Tablet [Liomny]272358116 / 16000No prior authorization
liothyronine sodium 0.05 MG Oral Tablet [Liomny]272358316 / 16000No prior authorization
liothyronine sodium 0.005 MG Oral Tablet [Liomny]272358516 / 16000No prior authorization

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

Plan-by-plan detail — liothyronine sodium 0.025 MG Oral Tablet [Liomny]

Liomny has 3 products in the corpus; this table is for liothyronine sodium 0.025 MG Oral Tablet [Liomny], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellpoint Chronic Care 2 (HMO-POS C-SNP)H2593-0062NoNoNo
Wellpoint Dual Advantage 2 (HMO D-SNP)H2593-0322NoNoNo
Wellpoint Full Dual Advantage (HMO D-SNP)H2593-0532NoNoNo
Wellpoint Full Dual Advantage 2 (HMO D-SNP)H2593-0482NoNoNo
Wellpoint Full Dual Advantage 2 (HMO D-SNP)H2593-0512NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0442NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0452NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0462NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0472NoNoNo
Wellpoint I CareMore Home Care 2 (HMO I-SNP)H2593-0032NoNoNo
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP)H2593-0402NoNoNo
Wellpoint Kidney Care (HMO-POS C-SNP)H2593-0312NoNoNo
Wellpoint Kidney Care (HMO-POS C-SNP)H2593-0432NoNoNo
Wellpoint Lung Care 2 (HMO-POS C-SNP)H2593-0052NoNoNo
Wellpoint Medicare Advantage 2 (HMO-POS)H2593-0012NoNoNo
Wellpoint Medicare Advantage 2 (HMO-POS)H2593-0292NoNoNo
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.

Liomny at other payers

Or see Liomny 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.