Benefily
Prior authorization required

Does Health Alliance Plan Of Michigan require prior authorization for Xeljanz?

Health Alliance Plan Of Michigan requires prior authorization for Xeljanz on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStatus
tofacitinib 5 MG Oral Tablet [Xeljanz]13575477 / 77Prior authorization required
24 HR tofacitinib 11 MG Extended Release Oral Tablet [Xeljanz]17410497 / 77Prior authorization required
tofacitinib 10 MG Oral Tablet [Xeljanz]20485687 / 77Prior authorization required
24 HR tofacitinib 22 MG Extended Release Oral Tablet [Xeljanz]22731157 / 77Prior authorization required
tofacitinib 1 MG/ML Oral Solution [Xeljanz]24784377 / 77Prior authorization required

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

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.

Xeljanz at other payers

Or see Xeljanz 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.