Benefily
Varies by plan

Does Arkansas Health & Wellness Health Plan, INC. require prior authorization for XIFAXAN?

Prior authorization for XIFAXAN differs across Arkansas Health & Wellness Health Plan, INC.'s Medicare Part D plans and product strengths — 1 of 2 XIFAXAN 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 productPlans coveringRequire prior authStep therapyQty limitStatus
rifaximin 200 MG Oral Tablet [XIFAXAN]5397890 / 5000Not on formulary
rifaximin 550 MG Oral Tablet [XIFAXAN]8566665 / 5505Prior authorization required

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

Plan-by-plan detail — rifaximin 550 MG Oral Tablet [XIFAXAN]

XIFAXAN has 2 products in the corpus; this table is for rifaximin 550 MG Oral Tablet [XIFAXAN], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare Dual Access (HMO-POS D-SNP)H9630-0105YesNoYes
Wellcare Dual Liberty (HMO-POS D-SNP)H9630-0115YesNoYes
Wellcare Dual Reserve (HMO-POS D-SNP)H9630-0145YesNoYes
Wellcare Giveback (HMO-POS)H9630-0085YesNoYes
Wellcare Simple (HMO-POS)H9630-0025YesNoYes
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.

XIFAXAN at other payers

Or see XIFAXAN 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.