Benefily
Varies by plan

Does Sunshine State Health Plan, INC. require prior authorization for Prograf?

Prior authorization for Prograf differs across Sunshine State Health Plan, INC.'s Medicare Part D plans and product strengths — 2 of 5 Prograf products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
tacrolimus 1 MG Oral Capsule [Prograf]1085130 / 24000Not on formulary
tacrolimus 5 MG Oral Capsule [Prograf]1085140 / 24000Not on formulary
tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]205260924 / 242400Prior authorization required
tacrolimus 1 MG Granules for Oral Suspension [Prograf]205270424 / 242400Prior authorization required
tacrolimus 0.5 MG Oral Capsule [Prograf]2611340 / 24000Not on formulary

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

Plan-by-plan detail — tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]

Prograf has 5 products in the corpus; this table is for tacrolimus 0.2 MG Granules for Oral Suspension [Prograf], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare Dual Access Sync (HMO D-SNP)H1032-2404YesNoNo
Wellcare Dual Access Sync (HMO D-SNP)H1032-2414YesNoNo
Wellcare Dual Access Sync (HMO D-SNP)H1032-2444YesNoNo
Wellcare Dual Access Sync (HMO D-SNP)H1032-2444YesNoNo
Wellcare Dual Reserve (HMO D-SNP)H1032-2024YesNoNo
Wellcare Giveback (HMO)H1032-1934YesNoNo
Wellcare Giveback (HMO)H1032-1954YesNoNo
Wellcare Giveback (HMO)H1032-1984YesNoNo
Wellcare Giveback (HMO)H1032-2004YesNoNo
Wellcare Giveback (HMO)H1032-2044YesNoNo
Wellcare Giveback (HMO)H1032-2104YesNoNo
Wellcare Giveback (HMO)H1032-2124YesNoNo
Wellcare Simple (HMO)H1032-1944YesNoNo
Wellcare Simple (HMO)H1032-1964YesNoNo
Wellcare Simple (HMO)H1032-1994YesNoNo
Wellcare Simple (HMO)H1032-2014YesNoNo
Wellcare Simple (HMO)H1032-2054YesNoNo
Wellcare Simple (HMO)H1032-2114YesNoNo
Wellcare Simple (HMO)H1032-2134YesNoNo
Wellcare Simple (HMO)H1032-2374YesNoNo
Wellcare Sunshine Health Dual Align (HMO D-SNP)H1032-2424YesNoNo
Wellcare Sunshine Health Dual Align (HMO D-SNP)H1032-2434YesNoNo
Wellcare Sunshine Health Dual Align (HMO D-SNP)H1032-2454YesNoNo
Wellcare Sunshine Health Dual Align (HMO D-SNP)H1032-2454YesNoNo
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.

Prograf at other payers

Or see Prograf 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.