Varies by plan

Does Careplus Health Plans, INC. require prior authorization for Iclusig?

Prior authorization for Iclusig differs across Careplus Health Plans, INC.'s Medicare Part D plans and product strengths — 3 of 4 Iclusig 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 product	Plans covering	Require prior auth	Qty limit	Status
ponatinib 15 MG Oral Tablet [Iclusig]1364358	36 / 36	36	36	Prior authorization required
ponatinib 45 MG Oral Tablet [Iclusig]1364362	36 / 36	36	36	Prior authorization required
ponatinib 30 MG Oral Tablet [Iclusig]1726639	36 / 36	36	36	Prior authorization required
ponatinib 10 MG Oral Tablet [Iclusig]2473042	0 / 36	0	0	Not on formulary

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

Plan-by-plan detail — ponatinib 15 MG Oral Tablet [Iclusig]

Iclusig has 4 products in the corpus; this table is for ponatinib 15 MG Oral Tablet [Iclusig], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
CareAccess (HMO)	H1019-144	5	Yes	No	Yes
CareAccess (HMO)	H1019-148	5	Yes	No	Yes
CareBreeze (HMO C-SNP)	H1019-154	5	Yes	No	Yes
CareBreeze Platinum (HMO C-SNP)	H1019-118	5	Yes	No	Yes
CareBreeze Platinum (HMO C-SNP)	H1019-123	5	Yes	No	Yes
CareBreeze Platinum (HMO C-SNP)	H1019-151	5	Yes	No	Yes
CareBreeze Platinum (HMO C-SNP)	H1019-151	5	Yes	No	Yes
CareBreeze Platinum (HMO-POS C-SNP)	H1019-124	5	Yes	No	Yes
CareComplete (HMO C-SNP)	H1019-150	5	Yes	No	Yes
CareComplete Platinum (HMO C-SNP)	H1019-109	5	Yes	No	Yes
CareComplete Platinum (HMO C-SNP)	H1019-121	5	Yes	No	Yes
CareComplete Platinum (HMO C-SNP)	H1019-147	5	Yes	No	Yes
CareComplete Platinum (HMO C-SNP)	H1019-147	5	Yes	No	Yes
CareComplete Platinum (HMO-POS C-SNP)	H1019-130	5	Yes	No	Yes
CareFree Giveback (HMO)	H1019-065	5	Yes	No	Yes
CareFree Giveback (HMO)	H1019-134	5	Yes	No	Yes
CareFree Giveback (HMO)	H1019-149	5	Yes	No	Yes
CareFree Platinum Giveback (HMO-POS)	H1019-135	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-094	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-104	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-104	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-136	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-138	5	Yes	No	Yes
CareFree Platinum Giveback (HMO)	H1019-139	5	Yes	No	Yes
CareNeeds Extra (HMO D-SNP)	H1019-152	5	Yes	No	Yes
CareNeeds Extra (HMO D-SNP)	H1019-153	5	Yes	No	Yes
CareNeeds Platinum (HMO D-SNP)	H1019-023	5	Yes	No	Yes
CareNeeds Platinum (HMO D-SNP)	H1019-146	5	Yes	No	Yes
CareNeeds Plus (HMO D-SNP)	H1019-073	5	Yes	No	Yes
CareOne Plus (HMO-POS)	H1019-001	5	Yes	No	Yes
CareOne Plus (HMO-POS)	H1019-043	5	Yes	No	Yes
CareOne Plus (HMO-POS)	H1019-057	5	Yes	No	Yes
CareOne Plus (HMO)	H1019-006	5	Yes	No	Yes
CareOne Plus (HMO)	H1019-103	5	Yes	No	Yes
CareOne Plus (HMO)	H1019-103	5	Yes	No	Yes
CareOne Plus (HMO)	H1019-113	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.

Iclusig at other payers

Or see Iclusig 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.