Does Physicians Health Choice Of Texas, LLC require prior authorization for Gengraf?
Physicians Health Choice Of Texas, LLC requires prior authorization for Gengraf 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 |
|---|---|---|---|---|---|
| cyclosporine, modified 100 MG Oral Capsule [Gengraf]835835 | 22 / 22 | 22 | 0 | 0 | Prior authorization required |
| cyclosporine, modified 25 MG Oral Capsule [Gengraf]835896 | 22 / 22 | 22 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — cyclosporine, modified 100 MG Oral Capsule [Gengraf]
Gengraf has 2 products in the corpus; this table is for cyclosporine, modified 100 MG Oral Capsule [Gengraf], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) | H4527-053 | 3 | Yes | No | No |
| AARP Medicare Advantage Essentials from UHC TX-11 (HMO-POS) | H4527-001 | 3 | Yes | No | No |
| AARP Medicare Advantage Essentials from UHC TX-12 (HMO-POS) | H4527-002 | 3 | Yes | No | No |
| AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) | H4527-013 | 3 | Yes | No | No |
| AARP Medicare Advantage Extras from UHC TX-50 (HMO-POS) | H4527-055 | 3 | Yes | No | No |
| AARP Medicare Advantage Extras from UHC TX-52 (HMO-POS) | H4527-056 | 3 | Yes | No | No |
| AARP Medicare Advantage Extras from UHC TX-53 (HMO-POS) | H4527-059 | 3 | Yes | No | No |
| AARP Medicare Advantage from UHC TX-0013 (HMO-POS) | H4527-005 | 3 | Yes | No | No |
| AARP Medicare Advantage from UHC TX-0015 (HMO-POS) | H4527-037 | 3 | Yes | No | No |
| AARP Medicare Advantage from UHC TX-0020 (HMO-POS) | H4527-045 | 3 | Yes | No | No |
| AARP Medicare Advantage from UHC TX-46 (HMO-POS) | H4527-052 | 3 | Yes | No | No |
| AARP Medicare Advantage from UHC TX-51 (HMO-POS) | H4527-058 | 3 | Yes | No | No |
| AARP Medicare Advantage Giveback from UHC TX-35 (HMO-POS) | H4527-048 | 3 | Yes | No | No |
| AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) | H4527-051 | 3 | Yes | No | No |
| UHC Complete Care TX-16 (HMO-POS C-SNP) | H4527-039 | 3 | Yes | No | No |
| UHC Complete Care TX-17 (HMO-POS C-SNP) | H4527-040 | 3 | Yes | No | No |
| UHC Complete Care TX-18 (HMO-POS C-SNP) | H4527-041 | 3 | Yes | No | No |
| UHC Complete Care TX-19 (HMO-POS C-SNP) | H4527-042 | 3 | Yes | No | No |
| UHC Dual Complete TX-D003 (HMO-POS D-SNP) | H4527-015 | 3 | Yes | No | No |
| UHC Dual Complete TX-Q2 (HMO-POS D-SNP) | H4527-057 | 3 | Yes | No | No |
| UHC Dual Complete TX-S4 (HMO-POS D-SNP) | H4527-054 | 3 | Yes | No | No |
| UHC Dual Complete TX-V002 (HMO-POS D-SNP) | H4527-003 | 3 | Yes | No | No |
- 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.
Gengraf 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.