Benefily
Varies by plan

Does Louisiana Health Service & Indemnity Company require prior authorization for Jakafi?

Prior authorization for Jakafi differs across Louisiana Health Service & Indemnity Company's Medicare Part D plans and product strengths — 3 of 5 Jakafi 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
ruxolitinib 10 MG Oral Tablet [Jakafi]11933373 / 3303Prior authorization required
ruxolitinib 5 MG Oral Tablet [Jakafi]11933413 / 3303Prior authorization required
ruxolitinib 15 MG Oral Tablet [Jakafi]11933453 / 3303Prior authorization required
ruxolitinib 20 MG Oral Tablet [Jakafi]11933490 / 3000Not on formulary
ruxolitinib 25 MG Oral Tablet [Jakafi]11933530 / 3000Not on formulary

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

Plan-by-plan detail — ruxolitinib 10 MG Oral Tablet [Jakafi]

Jakafi has 5 products in the corpus; this table is for ruxolitinib 10 MG Oral Tablet [Jakafi], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue adVantage Liberty (PPO)H1248-0075YesNoYes
Blue adVantage Premier (PPO)H1248-0045YesNoYes
Blue adVantage Thrive (PPO)H1248-0145YesNoYes
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.

Jakafi at other payers

Or see Jakafi 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.