Benefily
Prior authorization required

Does American Health Plan Of Ms, INC. require prior authorization for Envarsus?

American Health Plan Of Ms, INC. requires prior authorization for Envarsus 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 productPlans coveringRequire prior authStep therapyQty limitStatus
24 HR tacrolimus 4 MG Extended Release Oral Tablet [Envarsus]16644401 / 1100Prior authorization required
24 HR tacrolimus 0.75 MG Extended Release Oral Tablet [Envarsus]16644581 / 1100Prior authorization required
24 HR tacrolimus 1 MG Extended Release Oral Tablet [Envarsus]16644631 / 1100Prior authorization required

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

Plan-by-plan detail — 24 HR tacrolimus 4 MG Extended Release Oral Tablet [Envarsus]

Envarsus has 3 products in the corpus; this table is for 24 HR tacrolimus 4 MG Extended Release Oral Tablet [Envarsus], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
American Health Advantage of Mississippi (HMO I-SNP)H9909-0011YesNoNo
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.

Envarsus at other payers

Or see Envarsus 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.