Does Allina Health And Aetna Insurance Company require prior authorization for Alvaiz?
Allina Health And Aetna Insurance Company requires prior authorization for Alvaiz 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 | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| eltrombopag 18 MG Oral Tablet [Alvaiz]2675193 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| eltrombopag 36 MG Oral Tablet [Alvaiz]2675197 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| eltrombopag 54 MG Oral Tablet [Alvaiz]2675201 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| eltrombopag 9 MG Oral Tablet [Alvaiz]2675205 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — eltrombopag 18 MG Oral Tablet [Alvaiz]
Alvaiz has 4 products in the corpus; this table is for eltrombopag 18 MG Oral Tablet [Alvaiz], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Allina Health Aetna Medicare Chronic (PPO C-SNP) | H3219-015 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Enhanced (PPO) | H3219-002 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Enhanced (PPO) | H3219-014 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Grand (PPO) | H3219-003 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Grand Extra (PPO) | H3219-004 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature (PPO) | H3219-001 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature (PPO) | H3219-012 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Signature Fit (PPO) | H3219-008 | 5 | Yes | No | Yes |
| Allina Health Aetna Medicare Value (PPO C-SNP) | H3219-016 | 5 | Yes | No | Yes |
- 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.
Alvaiz at other payers
Or see Alvaiz across every payer at once.
- Aetna (CVS Health)
- Devoted Health
- Kaiser Permanente
- Molina Healthcare
- Zing Health Of Michigan, INC.
- Blue Cross Blue Shield (affiliate)
- Bluecross Blueshield Of Tennessee, INC.
- Central Health Plan Of California, INC.
- Clover Health
- Atrio Health Plans
- Mount Carmel Health Plan, INC.
- Pacificsource Community Health Plans
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.