Does Network Health Insurance Corporation require prior authorization for Xolair?
Network Health Insurance Corporation requires prior authorization for Xolair 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 | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| omalizumab 150 MG Injection [Xolair]1657212 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 1 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2058946 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 0.5 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2058950 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 2 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2663918 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 2 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2663923 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 1 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2673761 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
| 0.5 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2673763 | 8 / 8 | 8 | 0 | 8 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — omalizumab 150 MG Injection [Xolair]
Xolair has 7 products in the corpus; this table is for omalizumab 150 MG Injection [Xolair], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Network Health Anywhere (PPO) | H5215-010 | 5 | Yes | No | Yes |
| Network Health Cares (PPO D-SNP) | H5215-007 | 5 | Yes | No | Yes |
| Network Health Choice (PPO) | H5215-011 | 5 | Yes | No | Yes |
| Network Health Go (PPO) | H5215-009 | 5 | Yes | No | Yes |
| Network Health PlusRx (PPO) | H5215-002 | 5 | Yes | No | Yes |
| Network Health PremierRx (PPO) | H5215-005 | 5 | Yes | No | Yes |
| Network Health Select (PPO) | H5215-008 | 5 | Yes | No | Yes |
| Network Health Zero (PPO) | H5215-012 | 5 | Yes | No | Yes |
- 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.
Xolair at other payers
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.