Benefily
No prior authorization

Does Bluecross Blueshield Of Tennessee, INC. require prior authorization for Selzentry?

Bluecross Blueshield Of Tennessee, INC. does not require prior authorization for Selzentry 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
maraviroc 20 MG/ML Oral Solution [Selzentry]185792517 / 170017No prior authorization
maraviroc 150 MG Oral Tablet [Selzentry]7292010 / 17000Not on formulary
maraviroc 300 MG Oral Tablet [Selzentry]7292030 / 17000Not on formulary

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

Plan-by-plan detail — maraviroc 20 MG/ML Oral Solution [Selzentry]

Selzentry has 3 products in the corpus; this table is for maraviroc 20 MG/ML Oral Solution [Selzentry], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
BlueAdvantage Diamond (PPO)H7917-0095NoNoYes
BlueAdvantage Diamond (PPO)H7917-0105NoNoYes
BlueAdvantage Diamond (PPO)H7917-0115NoNoYes
BlueAdvantage Extra (PPO)H7917-0415NoNoYes
BlueAdvantage Garnet (PPO)H7917-0325NoNoYes
BlueAdvantage Garnet (PPO)H7917-0335NoNoYes
BlueAdvantage Ruby (PPO)H7917-0125NoNoYes
BlueAdvantage Ruby (PPO)H7917-0135NoNoYes
BlueAdvantage Ruby (PPO)H7917-0145NoNoYes
BlueAdvantage Ruby (PPO)H7917-0155NoNoYes
BlueAdvantage Sapphire (PPO)H7917-0305NoNoYes
BlueAdvantage Sapphire (PPO)H7917-0315NoNoYes
BlueAdvantage Sapphire (PPO)H7917-0385NoNoYes
BlueAdvantage Sapphire (PPO)H7917-0405NoNoYes
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0445NoNoYes
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0455NoNoYes
BlueAdvantage Total Heart and Diabetes Plus (PPO C-SNP)H7917-0465NoNoYes
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.

Selzentry at other payers

Or see Selzentry 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.