Benefily
Prior authorization required

Does Providence Health Assurance require prior authorization for Rinvoq?

Providence Health Assurance requires prior authorization for Rinvoq 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
24 HR upadacitinib 15 MG Extended Release Oral Tablet [Rinvoq]21969007 / 7707Prior authorization required
24 HR upadacitinib 30 MG Extended Release Oral Tablet [Rinvoq]25900547 / 7707Prior authorization required
24 HR upadacitinib 45 MG Extended Release Oral Tablet [Rinvoq]25969607 / 7707Prior authorization required
upadacitinib 1 MG/ML Oral Solution [Rinvoq]26810197 / 7707Prior authorization required

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

Plan-by-plan detail — 24 HR upadacitinib 15 MG Extended Release Oral Tablet [Rinvoq]

Rinvoq has 4 products in the corpus; this table is for 24 HR upadacitinib 15 MG Extended Release Oral Tablet [Rinvoq], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Providence Medicare Dual Plus (HMO D-SNP)H9047-0435YesNoYes
Providence Medicare Extra + Rx (HMO)H9047-0645YesNoYes
Providence Medicare Extra Part B Only + Rx (HMO)H9047-0135YesNoYes
Providence Medicare Pine + Rx (HMO)H9047-0635YesNoYes
Providence Medicare Prime + Rx (HMO)H9047-0375YesNoYes
Providence Medicare Sycamore + Rx (HMO)H9047-0665YesNoYes
Providence Medicare Timber + Rx (HMO)H9047-0545YesNoYes
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.

Rinvoq at other payers

Or see Rinvoq 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.