Benefily
Prior authorization required

Does SCAN Health Plan require prior authorization for Rubraca?

SCAN Health Plan requires prior authorization for Rubraca 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
rucaparib 300 MG Oral Tablet [Rubraca]186259074 / 747400Prior authorization required
rucaparib 200 MG Oral Tablet [Rubraca]186259574 / 747400Prior authorization required
rucaparib 250 MG Oral Tablet [Rubraca]192158974 / 747400Prior authorization required

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

Plan-by-plan detail — rucaparib 300 MG Oral Tablet [Rubraca]

Rubraca has 3 products in the corpus; this table is for rucaparib 300 MG Oral Tablet [Rubraca], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
SCAN Affirm partnered with Included LGBTQ+ Health (HMO)H5425-0925YesNoNo
SCAN Affirm partnered with Included LGBTQ+ Health (HMO)H5425-0965YesNoNo
SCAN Affirm partnered with Included LGBTQ+ Health (HMO)H5425-1075YesNoNo
SCAN Allied (HMO)H5425-1185YesNoNo
SCAN Allied (HMO)H5425-1235YesNoNo
SCAN Alta (HMO)H5425-0825YesNoNo
SCAN Balance (HMO C-SNP)H0978-0025YesNoNo
SCAN Balance (HMO C-SNP)H1822-0025YesNoNo
SCAN Balance (HMO C-SNP)H5244-0025YesNoNo
SCAN Balance (HMO C-SNP)H5425-0345YesNoNo
SCAN Balance (HMO C-SNP)H5425-0705YesNoNo
SCAN Balance (HMO C-SNP)H5425-0765YesNoNo
SCAN Balance (HMO C-SNP)H5425-1025YesNoNo
SCAN Balance (HMO C-SNP)H5425-1045YesNoNo
SCAN Balance (HMO C-SNP)H5425-1055YesNoNo
SCAN Balance (HMO C-SNP)H5425-1065YesNoNo
SCAN Balance (HMO C-SNP)H5425-1295YesNoNo
SCAN Balance Texas (HMO C-SNP)H8902-0025YesNoNo
SCAN Classic (HMO)H0978-0015YesNoNo
SCAN Classic (HMO)H1822-0015YesNoNo
SCAN Classic (HMO)H5244-0015YesNoNo
SCAN Classic (HMO)H5425-0015YesNoNo
SCAN Classic (HMO)H5425-0055YesNoNo
SCAN Classic (HMO)H5425-0065YesNoNo
SCAN Classic (HMO)H5425-0075YesNoNo
SCAN Classic (HMO)H5425-0085YesNoNo
SCAN Classic (HMO)H5425-0095YesNoNo
SCAN Classic (HMO)H5425-0195YesNoNo
SCAN Classic (HMO)H5425-0695YesNoNo
SCAN Classic (HMO)H5425-0755YesNoNo
SCAN Classic (HMO)H5425-1015YesNoNo
SCAN Classic (HMO)H5425-1285YesNoNo
SCAN Classic Texas (HMO)H8902-0105YesNoNo
SCAN Classic WA (HMO)H4026-0015YesNoNo
SCAN Compass (HMO)H5425-1245YesNoNo
SCAN Connections (HMO D-SNP)H0976-0015YesNoNo
SCAN Connections at Home (HMO D-SNP)H0976-0025YesNoNo
SCAN Desert Choice (HMO)H5425-1355YesNoNo
SCAN Embrace (HMO I-SNP)H5425-0865YesNoNo
SCAN Embrace (HMO I-SNP)H5425-0875YesNoNo
SCAN Embrace (HMO-POS I-SNP)H1822-0055YesNoNo
SCAN Embrace (HMO-POS I-SNP)H5425-0915YesNoNo
SCAN Embrace Together (HMO I-SNP)H5425-1315YesNoNo
SCAN Embrace Together (HMO-POS I-SNP)H1822-0085YesNoNo
SCAN Embrace Together (HMO-POS I-SNP)H5425-1325YesNoNo
SCAN Essential Savings (HMO)H5425-1335YesNoNo
SCAN Inspired by women for women (HMO)H5425-1005YesNoNo
SCAN MyChoice (HMO)H0978-0115YesNoNo
SCAN MyChoice (HMO)H1822-0075YesNoNo
SCAN MyChoice (HMO)H5244-0055YesNoNo
SCAN MyChoice (HMO)H5425-1085YesNoNo
SCAN MyChoice (HMO)H5425-1095YesNoNo
SCAN MyChoice (HMO)H5425-1105YesNoNo
SCAN MyChoice (HMO)H5425-1195YesNoNo
SCAN MyChoice (HMO)H5425-1205YesNoNo
SCAN MyChoice (HMO)H5425-1215YesNoNo
SCAN MyChoice (HMO)H5425-1305YesNoNo
SCAN MyChoice Texas (HMO)H8902-0115YesNoNo
SCAN MyChoice WA (HMO)H4026-0025YesNoNo
SCAN Prime (HMO)H5425-0655YesNoNo
SCAN Select (HMO)H5425-1345YesNoNo
SCAN Strive (HMO C-SNP)H0978-0105YesNoNo
SCAN Strive (HMO C-SNP)H1822-0065YesNoNo
SCAN Strive (HMO C-SNP)H5244-0045YesNoNo
SCAN Strive (HMO C-SNP)H5425-0975YesNoNo
SCAN Strive (HMO C-SNP)H5425-0985YesNoNo
SCAN Strive Texas (HMO C-SNP)H8902-0095YesNoNo
SCAN Venture (HMO)H5425-0845YesNoNo
SCAN Venture (HMO)H5425-0855YesNoNo
Sutter Senior Advantage, a SCAN Medicare Plan (HMO)H5425-1255YesNoNo
Sutter Senior Advantage, a SCAN Medicare Plan (HMO)H5425-1265YesNoNo
Sutter Senior Advantage, a SCAN Medicare Plan (HMO)H5425-1275YesNoNo
VillageHealth (HMO-POS C-SNP)H5943-0035YesNoNo
VillageHealth (HMO-POS C-SNP)H5943-0045YesNoNo
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.

Rubraca at other payers

Or see Rubraca 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.