Benefily
Prior authorization required

Does Priority Health require prior authorization for Gengraf?

Priority Health 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 productPlans coveringRequire prior authStep therapyQty limitStatus
cyclosporine, modified 100 MG Oral Capsule [Gengraf]83583537 / 373700Prior authorization required
cyclosporine, modified 25 MG Oral Capsule [Gengraf]83589637 / 373700Prior 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.

PlanContractTierPrior authStep therapyQty limit
PriorityMedicare (HMO-POS)H2320-0282YesNoNo
PriorityMedicare (HMO-POS)H2320-0282YesNoNo
PriorityMedicare (HMO-POS)H2320-0282YesNoNo
PriorityMedicare (HMO-POS)H2320-0282YesNoNo
PriorityMedicare (HMO-POS)H2320-0282YesNoNo
PriorityMedicare Edge (PPO)H4875-0202YesNoNo
PriorityMedicare Edge (PPO)H4875-0202YesNoNo
PriorityMedicare Edge (PPO)H4875-0202YesNoNo
PriorityMedicare Key (HMO-POS)H2320-0222YesNoNo
PriorityMedicare Key (HMO-POS)H2320-0222YesNoNo
PriorityMedicare Key (HMO-POS)H2320-0222YesNoNo
PriorityMedicare Key (HMO-POS)H2320-0222YesNoNo
PriorityMedicare Key (HMO-POS)H2320-0222YesNoNo
PriorityMedicare Merit (PPO)H4875-0162YesNoNo
PriorityMedicare Merit (PPO)H4875-0162YesNoNo
PriorityMedicare Merit (PPO)H4875-0162YesNoNo
PriorityMedicare Merit (PPO)H4875-0162YesNoNo
PriorityMedicare Merit (PPO)H4875-0162YesNoNo
PriorityMedicare Smart Savings (HMO-POS)H2320-0322YesNoNo
PriorityMedicare Smart Savings (HMO-POS)H2320-0322YesNoNo
PriorityMedicare Smart Savings (HMO-POS)H2320-0322YesNoNo
PriorityMedicare Thrive (PPO)H4875-0242YesNoNo
PriorityMedicare Thrive (PPO)H4875-0242YesNoNo
PriorityMedicare Thrive Plus (PPO)H4875-0182YesNoNo
PriorityMedicare Thrive Plus (PPO)H4875-0182YesNoNo
PriorityMedicare Thrive Plus (PPO)H4875-0182YesNoNo
PriorityMedicare Thrive Plus (PPO)H4875-0182YesNoNo
PriorityMedicare Thrive Plus (PPO)H4875-0182YesNoNo
PriorityMedicare Value (HMO-POS)H2320-0292YesNoNo
PriorityMedicare Value (HMO-POS)H2320-0292YesNoNo
PriorityMedicare Value (HMO-POS)H2320-0292YesNoNo
PriorityMedicare Value (HMO-POS)H2320-0292YesNoNo
PriorityMedicare Value (HMO-POS)H2320-0292YesNoNo
PriorityMedicare Vintage (HMO-POS)H2320-0312YesNoNo
PriorityMedicare Vital (PPO)H4875-0222YesNoNo
PriorityMedicare Vital (PPO)H4875-0222YesNoNo
PriorityMedicare Vital (PPO)H4875-0222YesNoNo
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.

Gengraf at other payers

Or see Gengraf 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.