Does Tufts Associated Health Maintenance Organization require prior authorization for Inqovi 5 Tablet Pack?
Tufts Associated Health Maintenance Organization requires prior authorization for Inqovi 5 Tablet Pack 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 |
|---|---|---|---|---|---|
| {5 (cedazuridine 100 MG / decitabine 35 MG Oral Tablet [Inqovi]) } Pack [Inqovi 5 Tablet Pack]2384465 | 21 / 21 | 21 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — {5 (cedazuridine 100 MG / decitabine 35 MG Oral Tablet [Inqovi]) } Pack [Inqovi 5 Tablet Pack]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Tufts Health Plan Senior Care Options (HMO D-SNP) | H8330-001 | 1 | Yes | No | No |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | H8330-002 | 1 | Yes | No | No |
| Tufts Medicare Preferred HMO Basic Rx (HMO) | H2256-026 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Basic Rx (HMO) | H2256-026 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Basic Rx (HMO) | H2256-026 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Basic Rx (HMO) | H2256-036 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx (HMO) | H2256-015 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx (HMO) | H2256-015 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx (HMO) | H2256-015 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx (HMO) | H2256-033 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx Plus (HMO) | H2256-001 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx Plus (HMO) | H2256-001 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Prime Rx Plus (HMO) | H2256-001 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Smart Saver Rx (HMO) | H2256-046 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Value Rx (HMO) | H2256-018 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Value Rx (HMO) | H2256-018 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Value Rx (HMO) | H2256-018 | 5 | Yes | No | No |
| Tufts Medicare Preferred HMO Value Rx (HMO) | H2256-034 | 5 | Yes | No | No |
| Tufts Medicare Preferred PPO RX (PPO) | H9907-002 | 5 | Yes | No | No |
| Tufts Medicare Preferred PPO RX (PPO) | H9907-002 | 5 | Yes | No | No |
| Tufts Medicare Preferred PPO RX (PPO) | H9907-002 | 5 | 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.
Inqovi 5 Tablet Pack 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.