Benefily
No prior authorization

Does Blue Cross Blue Shield (affiliate) require prior authorization for Jantoven?

Blue Cross Blue Shield (affiliate) does not require prior authorization for Jantoven on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • 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
warfarin sodium 1 MG Oral Tablet [Jantoven]855292269 / 269000No prior authorization
warfarin sodium 10 MG Oral Tablet [Jantoven]855300269 / 269000No prior authorization
warfarin sodium 2 MG Oral Tablet [Jantoven]855306269 / 269000No prior authorization
warfarin sodium 2.5 MG Oral Tablet [Jantoven]855316147 / 269000No prior authorization
warfarin sodium 3 MG Oral Tablet [Jantoven]8553220 / 269000Not on formulary
warfarin sodium 4 MG Oral Tablet [Jantoven]8553280 / 269000Not on formulary
warfarin sodium 5 MG Oral Tablet [Jantoven]8553360 / 269000Not on formulary
warfarin sodium 6 MG Oral Tablet [Jantoven]8553420 / 269000Not on formulary
warfarin sodium 7.5 MG Oral Tablet [Jantoven]8553480 / 269000Not on formulary

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

Plan-by-plan detail — warfarin sodium 1 MG Oral Tablet [Jantoven]

Jantoven has 9 products in the corpus; this table is for warfarin sodium 1 MG Oral Tablet [Jantoven], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Dual Advantage (HMO D-SNP)H5422-0181NoNoNo
Anthem Extra Help (HMO-POS)H5422-0131NoNoNo
Anthem Full Dual Advantage (HMO D-SNP)H5422-0191NoNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0101NoNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0101NoNoNo
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0111NoNoNo
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0041NoNoNo
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0101NoNoNo
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0141NoNoNo
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0151NoNoNo
Anthem I CareMore Home Care (HMO I-SNP)H0544-0051NoNoNo
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0151NoNoNo
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0201NoNoNo
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0141NoNoNo
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0191NoNoNo
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0161NoNoNo
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0171NoNoNo
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0111NoNoNo
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0131NoNoNo
Anthem I CareMore Medicare Advantage 2 (HMO-POS)H0544-0021NoNoNo
Anthem I CareMore Premium Savings (HMO-POS)H4161-0121NoNoNo
Anthem Kidney Care (HMO-POS C-SNP)H5422-0151NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0561NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0611NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0621NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0631NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0641NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0651NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0951NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-0961NoNoNo
Anthem Medicare Advantage (HMO-POS)H0544-1081NoNoNo
Anthem Medicare Advantage (HMO-POS)H5422-0111NoNoNo
Anthem Prime (HMO-POS)H4161-0021NoNoNo
Anthem Prime (HMO-POS)H4161-0031NoNoNo
Anthem Prime (HMO-POS)H4161-0041NoNoNo
Anthem Prime (HMO-POS)H4161-0051NoNoNo
Anthem Prime (HMO-POS)H4161-0061NoNoNo
Anthem Prime (HMO-POS)H4161-0071NoNoNo
Anthem Prime (HMO-POS)H4161-0091NoNoNo
Anthem Prime (HMO-POS)H4161-0101NoNoNo
Anthem Select (HMO-POS)H0544-0581NoNoNo
Anthem Select (HMO-POS)H0544-0661NoNoNo
Anthem Select (HMO-POS)H0544-0691NoNoNo
Anthem Select (HMO-POS)H0544-0911NoNoNo
Anthem Select (HMO-POS)H0544-0981NoNoNo
Blue Advantage Choice (PPO)H0104-0161NoNoNo
Blue Advantage Complete (PPO)H0104-0121NoNoNo
Blue Advantage Complete (PPO)H0104-0141NoNoNo
Blue Advantage Premier (PPO)H0104-0151NoNoNo
Blue Cross Medicare Advantage Choice (PPO)H5959-0091NoNoNo
Blue Cross Medicare Advantage Choice (PPO)H5959-0141NoNoNo
Blue Cross Medicare Advantage Choice (PPO)H5959-0141NoNoNo
Blue Cross Medicare Advantage Comfort (PPO)H5959-0151NoNoNo
Blue Cross Medicare Advantage Comfort (PPO)H5959-0161NoNoNo
Blue Cross Medicare Advantage Complete (PPO)H5959-0101NoNoNo
Blue Cross Medicare Advantage Complete (PPO)H5959-0101NoNoNo
Blue Cross Medicare Advantage Complete (PPO)H5959-0111NoNoNo
Blue Cross Medicare Advantage Core (PPO)H5959-0121NoNoNo
Blue Cross Medicare Advantage Core (PPO)H5959-0131NoNoNo
Blue Cross Medicare Advantage Core (PPO)H5959-0131NoNoNo
Blue Cross Medicare Advantage Secure (HMO)H8547-0011NoNoNo
Blue Medicare Advantage Classic PPO (PPO)H5900-0081NoNoNo
Blue Medicare Advantage Enhanced PPO (PPO)H5900-0041NoNoNo
Blue Medicare Advantage PPO (PPO)H5900-0011NoNoNo
Blue Medicare Choice (HMO)H3449-0261NoNoNo
Blue Medicare Enhanced (HMO-POS)H3449-0241NoNoNo
Blue Medicare Enhanced (HMO-POS)H3449-0241NoNoNo
Blue Medicare Enhanced (HMO-POS)H3449-0241NoNoNo
Blue Medicare Essential (HMO)H3449-0271NoNoNo
Blue Medicare Essential (HMO)H3449-0271NoNoNo
Blue Medicare Essential Plus (HMO-POS)H3449-0231NoNoNo
Blue Medicare Essential Plus (HMO-POS)H3449-0231NoNoNo
Blue Medicare Essential Plus (HMO-POS)H3449-0231NoNoNo
Blue Medicare Essential Plus (HMO-POS)H3449-0231NoNoNo
Blue Medicare PPO Enhanced (PPO)H3404-0031NoNoNo
Blue Medicare PPO Enhanced (PPO)H3404-0031NoNoNo
Blue Medicare Rx Enhanced (PDP)S5540-0041NoNoNo
Blue Medicare Rx Standard (PDP)S5540-0021NoNoNo
Blue MedicareRx Essentials (PDP)S5726-0201NoNoNo
Blue MedicareRx Plus (PDP)S5726-0141NoNoNo
Blue MedicareRx Value (PDP)S5726-0131NoNoNo
BlueCHiP for Medicare Access (HMO-POS)H4152-0221NoNoNo
BlueCHiP for Medicare Enhanced (HMO-POS)H4152-0131NoNoNo
BlueCHiP for Medicare Essential (HMO-POS)H4152-0231NoNoNo
BlueCHiP for Medicare Extra (HMO-POS)H4152-0181NoNoNo
BlueMedicare Complete Rx (PDP)S5904-0021NoNoNo
BlueMedicare Premier Rx (PDP)S5904-0011NoNoNo
BlueMedicare Select (PPO)H5434-0021NoNoNo
BlueMedicare Select (PPO)H5434-0451NoNoNo
BlueMedicare Value (PPO)H5434-0231NoNoNo
BlueMedicare Value (PPO)H5434-0241NoNoNo
BlueMedicare Value (PPO)H5434-0251NoNoNo
BlueMedicare Value (PPO)H5434-0261NoNoNo
BlueMedicare Value (PPO)H5434-0301NoNoNo
BlueMedicare Value (PPO)H5434-0311NoNoNo
BlueMedicare Value (PPO)H5434-0341NoNoNo
BlueMedicare Value (PPO)H5434-0351NoNoNo
BlueMedicare Value (PPO)H5434-0361NoNoNo
BlueRI for Duals (HMO D-SNP)H4152-0211NoNoNo
BlueRx Enhanced Plus (PDP)S1030-0011NoNoNo
Showing 100 of 269 covering plans.
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.

Jantoven at other payers

Or see Jantoven 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.