Varies by plan

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

Prior authorization for Spiriva differs across Excellus Health Plan, INC.'s Medicare Part D plans and product strengths — 3 of 3 Spiriva 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.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
60 ACTUAT tiotropium 0.0025 MG/ACTUAT Inhalation Spray [Spiriva]1552004	16 / 16	16	16	Prior authorization required
60 ACTUAT tiotropium 0.00125 MG/ACTUAT Inhalation Spray [Spiriva]1667882	16 / 16	16	16	Prior authorization required
tiotropium 0.018 MG Inhalation Powder [Spiriva]580261	16 / 16	0	0	No prior authorization

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

Plan-by-plan detail — 60 ACTUAT tiotropium 0.0025 MG/ACTUAT Inhalation Spray [Spiriva]

Spiriva has 3 products in the corpus; this table is for 60 ACTUAT tiotropium 0.0025 MG/ACTUAT Inhalation Spray [Spiriva], 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	4	Yes	No	Yes
Medicare Blue Choice Optimum (HMO-POS)	H3351-006	4	Yes	No	Yes
Medicare Blue Choice Prime (HMO)	H3351-023	4	Yes	No	Yes
Medicare BlueActive (PPO)	H3335-055	4	Yes	No	Yes
Medicare BlueBalanced (PPO)	H3335-062	4	Yes	No	Yes
Medicare BlueClassic (PPO)	H3335-038	4	Yes	No	Yes
Medicare BlueEnhanced (PPO)	H3335-015	4	Yes	No	Yes
Medicare BlueEssential (PPO)	H3335-053	4	Yes	No	Yes
Medicare BluePlus (PPO)	H3335-018	4	Yes	No	Yes
Medicare BlueVital (PPO)	H3335-061	4	Yes	No	Yes
Univera SeniorChoice Advanced (HMO-POS)	H3351-019	4	Yes	No	Yes
Univera SeniorChoice Basic (HMO)	H3351-017	4	Yes	No	Yes
Univera SeniorChoice Core (PPO)	H3335-060	4	Yes	No	Yes
Univera SeniorChoice Extra (HMO)	H3351-020	4	Yes	No	Yes
Univera SeniorChoice Secure (HMO-POS)	H3351-002	4	Yes	No	Yes
Univera SeniorChoice Value Plus (HMO-POS)	H3351-012	4	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.

Spiriva at other payers

Or see Spiriva 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.