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Coverage / Highmark / Retin-A Micro Pump (tretinoin) gel / acne vulgaris

Retin-A Micro Pump (tretinoin) gel — Highmark

acne vulgaris

Initial criteria

The member has a diagnosis of acne vulgaris (ICD-10: L70.0).

Approval duration

12 months

Provenance

View official policy PDF

Plan: Highmark
Drug: Retin-A Micro Pump (tretinoin) gel
Indication: acne vulgaris
Last seen: 2025-10-06
Hash: 1dc5aeeba147…

Disclaimer: Educational only. Coverage varies by employer group and formulary. Always verify with the plan.

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Structured prior authorization and step-therapy criteria for commercial health plans. Built by pharmacists for healthcare professionals.

Disclaimer: Educational use only. Coverage varies by employer group and formulary. Always verify with the plan.

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