Benefily
Varies by plan

Does Centene (WellCare) require prior authorization for Prograf?

Prior authorization for Prograf differs across Centene (WellCare)'s Medicare Part D plans and product strengths — 2 of 5 Prograf 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
tacrolimus 1 MG Oral Capsule [Prograf]1085130 / 197000Not on formulary
tacrolimus 5 MG Oral Capsule [Prograf]1085140 / 197000Not on formulary
tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]2052609197 / 19719700Prior authorization required
tacrolimus 1 MG Granules for Oral Suspension [Prograf]2052704197 / 19719700Prior authorization required
tacrolimus 0.5 MG Oral Capsule [Prograf]2611340 / 197000Not on formulary

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

Plan-by-plan detail — tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]

Prograf has 5 products in the corpus; this table is for tacrolimus 0.2 MG Granules for Oral Suspension [Prograf], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare 'Ohana Dual Align (HMO-POS D-SNP)H9916-0014YesNoNo
Wellcare Assist (HMO-POS)H0913-0154YesNoNo
Wellcare Assist (HMO-POS)H1112-0434YesNoNo
Wellcare Assist (HMO-POS)H2491-0104YesNoNo
Wellcare Assist (HMO-POS)H4847-0054YesNoNo
Wellcare Assist (HMO-POS)H9730-0104YesNoNo
Wellcare Assist (HMO)H0174-0094YesNoNo
Wellcare Assist Open (PPO)H1914-0094YesNoNo
Wellcare Assist Open (PPO)H7326-0074YesNoNo
Wellcare CalViva Health Dual Align (HMO D-SNP)H3561-0074YesNoNo
Wellcare Classic (PDP)S4802-0124YesNoNo
Wellcare Classic (PDP)S4802-0134YesNoNo
Wellcare Classic (PDP)S4802-0144YesNoNo
Wellcare Classic (PDP)S4802-0204YesNoNo
Wellcare Classic (PDP)S4802-0214YesNoNo
Wellcare Classic (PDP)S4802-0694YesNoNo
Wellcare Classic (PDP)S4802-0704YesNoNo
Wellcare Classic (PDP)S4802-0714YesNoNo
Wellcare Classic (PDP)S4802-0724YesNoNo
Wellcare Classic (PDP)S4802-0734YesNoNo
Wellcare Classic (PDP)S4802-0744YesNoNo
Wellcare Classic (PDP)S4802-0754YesNoNo
Wellcare Classic (PDP)S4802-0764YesNoNo
Wellcare Classic (PDP)S4802-0774YesNoNo
Wellcare Classic (PDP)S4802-0784YesNoNo
Wellcare Classic (PDP)S4802-0794YesNoNo
Wellcare Classic (PDP)S4802-0804YesNoNo
Wellcare Classic (PDP)S4802-0814YesNoNo
Wellcare Classic (PDP)S4802-0824YesNoNo
Wellcare Classic (PDP)S4802-0834YesNoNo
Wellcare Classic (PDP)S4802-0844YesNoNo
Wellcare Classic (PDP)S4802-0854YesNoNo
Wellcare Classic (PDP)S4802-0864YesNoNo
Wellcare Classic (PDP)S4802-0874YesNoNo
Wellcare Classic (PDP)S4802-0884YesNoNo
Wellcare Classic (PDP)S4802-0894YesNoNo
Wellcare Classic (PDP)S4802-0904YesNoNo
Wellcare Classic (PDP)S4802-0914YesNoNo
Wellcare Classic (PDP)S4802-0924YesNoNo
Wellcare Classic (PDP)S4802-0934YesNoNo
Wellcare Classic (PDP)S4802-0944YesNoNo
Wellcare Classic (PDP)S4802-0954YesNoNo
Wellcare Classic (PDP)S4802-0964YesNoNo
Wellcare Classic (PDP)S4802-0974YesNoNo
Wellcare Dual Access (HMO D-SNP)H0174-0044YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0351-0664YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0351-0684YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0712-0054YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1112-0064YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1112-0474YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1862-0044YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H2491-0334YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H2491-0334YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H4073-0024YesNoNo
Wellcare Dual Access (HMO-POS D-SNP)H9364-0024YesNoNo
Wellcare Dual Access Open (PPO D-SNP)H0074-0044YesNoNo
Wellcare Dual Access Open (PPO D-SNP)H0111-0044YesNoNo
Wellcare Dual Access Open (PPO D-SNP)H4537-0044YesNoNo
Wellcare Dual Access Open (PPO D-SNP)H5965-0064YesNoNo
Wellcare Dual Access Open (PPO D-SNP)H7518-0034YesNoNo
Wellcare Dual Access Sync (HMO-POS D-SNP)H9730-0034YesNoNo
Wellcare Dual Access Sync Open (PPO D-SNP)H3975-0044YesNoNo
Wellcare Dual Liberty (HMO D-SNP)H0174-0064YesNoNo
Wellcare Dual Liberty (HMO D-SNP)H0712-0294YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H1112-0334YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H2491-0324YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H2491-0324YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H4073-0044YesNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H9364-0034YesNoNo
Wellcare Dual Liberty Open (PPO D-SNP)H1914-0084YesNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0234YesNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0244YesNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0254YesNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0264YesNoNo
Wellcare Dual Liberty Sync (HMO-POS D-SNP)H1862-0034YesNoNo
Wellcare Dual Liberty Sync (HMO-POS D-SNP)H9730-0044YesNoNo
Wellcare Dual Liberty Sync Open (PPO D-SNP)H5965-0044YesNoNo
Wellcare Dual Reserve (HMO D-SNP)H0174-0224YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1112-0464YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1112-0484YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1862-0064YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H2491-0254YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H4073-0034YesNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H9730-0114YesNoNo
Wellcare Fidelis Dual Align (HMO D-SNP)H0913-0134YesNoNo
Wellcare Giveback (HMO-POS)H0712-0324YesNoNo
Wellcare Giveback (HMO-POS)H0913-0214YesNoNo
Wellcare Giveback (HMO-POS)H1112-0424YesNoNo
Wellcare Giveback (HMO-POS)H2491-0314YesNoNo
Wellcare Giveback (HMO-POS)H4847-0074YesNoNo
Wellcare Giveback (HMO-POS)H9364-0044YesNoNo
Wellcare Giveback (HMO-POS)H9730-0074YesNoNo
Wellcare Giveback (HMO)H0174-0174YesNoNo
Wellcare Giveback (HMO)H0174-0184YesNoNo
Wellcare Giveback (HMO)H0174-0194YesNoNo
Wellcare Giveback (HMO)H0174-0204YesNoNo
Wellcare Giveback (HMO)H0174-0214YesNoNo
Wellcare Giveback (HMO)H0351-0544YesNoNo
Wellcare Giveback (HMO)H0351-0644YesNoNo
Wellcare Giveback (HMO)H5087-0324YesNoNo
Showing 100 of 197 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.

Prograf at other payers

Or see Prograf 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.