Prior authorization required

Does Amerihealth Caritas Vip Next, INC. require prior authorization for Xeljanz?

Amerihealth Caritas Vip Next, INC. requires prior authorization for Xeljanz 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	Qty limit	Status
tofacitinib 5 MG Oral Tablet [Xeljanz]1357547	2 / 2	2	2	Prior authorization required
24 HR tofacitinib 11 MG Extended Release Oral Tablet [Xeljanz]1741049	2 / 2	2	2	Prior authorization required
tofacitinib 10 MG Oral Tablet [Xeljanz]2048568	2 / 2	2	2	Prior authorization required
24 HR tofacitinib 22 MG Extended Release Oral Tablet [Xeljanz]2273115	2 / 2	2	2	Prior authorization required
tofacitinib 1 MG/ML Oral Solution [Xeljanz]2478437	2 / 2	2	2	Prior authorization required

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

Plan-by-plan detail — tofacitinib 5 MG Oral Tablet [Xeljanz]

Xeljanz has 5 products in the corpus; this table is for tofacitinib 5 MG Oral Tablet [Xeljanz], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
AmeriHealth Caritas VIP Care (HMO D-SNP)	H0738-001	5	Yes	No	Yes
AmeriHealth Caritas VIP Care Choice (HMO D-SNP)	H0738-002	5	Yes	No	Yes

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.

Xeljanz at other payers

Or see Xeljanz 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.