Does Allina Health And Aetna Insurance Company require prior authorization for Xalkori?
Prior authorization for Xalkori differs across Allina Health And Aetna Insurance Company's Medicare Part D plans and product strengths — 4 of 5 Xalkori 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 | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| crizotinib 200 MG Oral Capsule [Xalkori]1148502 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| crizotinib 250 MG Oral Capsule [Xalkori]1148506 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| crizotinib 150 MG Oral Pellet [Xalkori]2670170 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| crizotinib 20 MG Oral Pellet [Xalkori]2670174 | 7 / 9 | 7 | 0 | 7 | Prior authorization required |
| crizotinib 50 MG Oral Pellet [Xalkori]2670178 | 0 / 9 | 0 | 0 | 0 | Not on formulary |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — crizotinib 200 MG Oral Capsule [Xalkori]
Xalkori has 5 products in the corpus; this table is for crizotinib 200 MG Oral Capsule [Xalkori], 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.
Xalkori at other payers
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.