Varies by plan

Does Mmm Healthcare, LLC require prior authorization for Bosulif?

Prior authorization for Bosulif differs across Mmm Healthcare, LLC's Medicare Part D plans and product strengths — 3 of 5 Bosulif 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
bosutinib 100 MG Oral Tablet [Bosulif]1307630	20 / 20	20	0	Prior authorization required
bosutinib 500 MG Oral Tablet [Bosulif]1307635	20 / 20	20	20	Prior authorization required
bosutinib 400 MG Oral Tablet [Bosulif]1987734	20 / 20	20	20	Prior authorization required
bosutinib 100 MG Oral Capsule [Bosulif]2672326	0 / 20	0	0	Not on formulary
bosutinib 50 MG Oral Capsule [Bosulif]2672328	0 / 20	0	0	Not on formulary

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

Plan-by-plan detail — bosutinib 100 MG Oral Tablet [Bosulif]

Bosulif has 5 products in the corpus; this table is for bosutinib 100 MG Oral Tablet [Bosulif], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
MMM Balance (HMO-POS)	H4004-073	6	Yes	No	No
MMM Balance (HMO-POS)	H4004-073	6	Yes	No	No
MMM Balance (HMO-POS)	H4004-073	6	Yes	No	No
MMM Combo Platino (HMO D-SNP)	H4004-068	6	Yes	No	No
MMM Deluxe (HMO-POS)	H4003-055	6	Yes	No	No
MMM Diamante Platino (HMO D-SNP)	H4003-017	6	Yes	No	No
MMM Dorado Platino (HMO D-SNP)	H4003-058	6	Yes	No	No
MMM Elite (HMO-POS)	H4003-034	6	Yes	No	No
MMM Flexi Platino (HMO D-SNP)	H4004-069	6	Yes	No	No
MMM Grandioso (HMO-POS)	H4004-070	6	Yes	No	No
MMM Mega Flex (HMO-POS)	H4004-071	6	Yes	No	No
MMM Plenitud (HMO-POS)	H4004-065	6	Yes	No	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	Yes	No	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	Yes	No	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	Yes	No	No
MMM Supremo (HMO C-SNP)	H4003-009	6	Yes	No	No
MMM Unico (HMO-POS)	H4003-019	6	Yes	No	No
MMM Valioso (HMO-POS)	H4004-066	6	Yes	No	No
PMC Max (HMO-POS)	H4004-056	6	Yes	No	No
PMC Premier Platino (HMO D-SNP)	H4004-048	6	Yes	No	No

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.

Bosulif at other payers

Or see Bosulif 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.