Prior authorization required

Does Medical Mutual Of Ohio require prior authorization for Xtandi?

Medical Mutual Of Ohio requires prior authorization for Xtandi 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 product	Plans covering	Require prior auth	Qty limit	Status
enzalutamide 40 MG Oral Capsule [Xtandi]1307309	16 / 16	16	16	Prior authorization required
enzalutamide 40 MG Oral Tablet [Xtandi]2390646	16 / 16	16	16	Prior authorization required
enzalutamide 80 MG Oral Tablet [Xtandi]2390650	16 / 16	16	16	Prior authorization required

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

Plan-by-plan detail — enzalutamide 40 MG Oral Capsule [Xtandi]

Xtandi has 3 products in the corpus; this table is for enzalutamide 40 MG Oral Capsule [Xtandi], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
MedMutual Advantage Access (PPO)	H4497-005	5	Yes	No	Yes
MedMutual Advantage Access (PPO)	H4497-005	5	Yes	No	Yes
MedMutual Advantage Choice (HMO)	H6723-002	5	Yes	No	Yes
MedMutual Advantage Choice (HMO)	H6723-002	5	Yes	No	Yes
MedMutual Advantage Classic (HMO)	H6723-001	5	Yes	No	Yes
MedMutual Advantage Classic (HMO)	H6723-001	5	Yes	No	Yes
MedMutual Advantage Plus (HMO)	H6723-003	5	Yes	No	Yes
MedMutual Advantage Plus (HMO)	H6723-003	5	Yes	No	Yes
MedMutual Advantage Preferred (PPO)	H4497-002	5	Yes	No	Yes
MedMutual Advantage Preferred (PPO)	H4497-002	5	Yes	No	Yes
MedMutual Advantage Premium (PPO)	H4497-003	5	Yes	No	Yes
MedMutual Advantage Premium (PPO)	H4497-003	5	Yes	No	Yes
MedMutual Advantage Select (PPO)	H4497-001	5	Yes	No	Yes
MedMutual Advantage Select (PPO)	H4497-001	5	Yes	No	Yes
MedMutual Advantage Signature (HMO-POS)	H6723-006	5	Yes	No	Yes
MedMutual Advantage Signature (HMO-POS)	H6723-006	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.

Xtandi at other payers

Or see Xtandi 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.