Varies by plan

Does Excellus Health Plan, INC. require prior authorization for Ibrance?

Prior authorization for Ibrance differs across Excellus Health Plan, INC.'s Medicare Part D plans and product strengths — 3 of 6 Ibrance 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
palbociclib 100 MG Oral Capsule [Ibrance]1601386	16 / 16	16	16	Prior authorization required
palbociclib 125 MG Oral Capsule [Ibrance]1601390	16 / 16	16	16	Prior authorization required
palbociclib 75 MG Oral Capsule [Ibrance]1601394	16 / 16	16	16	Prior authorization required
palbociclib 100 MG Oral Tablet [Ibrance]2284104	0 / 16	0	0	Not on formulary
palbociclib 125 MG Oral Tablet [Ibrance]2284106	0 / 16	0	0	Not on formulary
palbociclib 75 MG Oral Tablet [Ibrance]2284108	0 / 16	0	0	Not on formulary

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

Plan-by-plan detail — palbociclib 100 MG Oral Capsule [Ibrance]

Ibrance has 6 products in the corpus; this table is for palbociclib 100 MG Oral Capsule [Ibrance], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Medicare Blue Choice Core (HMO)	H3351-022	5	Yes	No	Yes
Medicare Blue Choice Optimum (HMO-POS)	H3351-006	5	Yes	No	Yes
Medicare Blue Choice Prime (HMO)	H3351-023	5	Yes	No	Yes
Medicare BlueActive (PPO)	H3335-055	5	Yes	No	Yes
Medicare BlueBalanced (PPO)	H3335-062	5	Yes	No	Yes
Medicare BlueClassic (PPO)	H3335-038	5	Yes	No	Yes
Medicare BlueEnhanced (PPO)	H3335-015	5	Yes	No	Yes
Medicare BlueEssential (PPO)	H3335-053	5	Yes	No	Yes
Medicare BluePlus (PPO)	H3335-018	5	Yes	No	Yes
Medicare BlueVital (PPO)	H3335-061	5	Yes	No	Yes
Univera SeniorChoice Advanced (HMO-POS)	H3351-019	5	Yes	No	Yes
Univera SeniorChoice Basic (HMO)	H3351-017	5	Yes	No	Yes
Univera SeniorChoice Core (PPO)	H3335-060	5	Yes	No	Yes
Univera SeniorChoice Extra (HMO)	H3351-020	5	Yes	No	Yes
Univera SeniorChoice Secure (HMO-POS)	H3351-002	5	Yes	No	Yes
Univera SeniorChoice Value Plus (HMO-POS)	H3351-012	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.

Ibrance at other payers

Or see Ibrance 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.