Varies by plan

Does Ultimate Health Plans, INC. require prior authorization for Jakafi?

Prior authorization for Jakafi differs across Ultimate Health Plans, INC.'s Medicare Part D plans and product strengths — 3 of 5 Jakafi 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 product	Plans covering	Require prior auth	Qty limit	Status
ruxolitinib 10 MG Oral Tablet [Jakafi]1193337	16 / 16	16	16	Prior authorization required
ruxolitinib 5 MG Oral Tablet [Jakafi]1193341	16 / 16	16	0	Prior authorization required
ruxolitinib 15 MG Oral Tablet [Jakafi]1193345	16 / 16	16	0	Prior authorization required
ruxolitinib 20 MG Oral Tablet [Jakafi]1193349	0 / 16	0	0	Not on formulary
ruxolitinib 25 MG Oral Tablet [Jakafi]1193353	0 / 16	0	0	Not on formulary

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

Plan-by-plan detail — ruxolitinib 10 MG Oral Tablet [Jakafi]

Jakafi has 5 products in the corpus; this table is for ruxolitinib 10 MG Oral Tablet [Jakafi], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Advantage Care by Ultimate (HMO C-SNP)	H2962-021	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-026	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-029	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-033	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-050	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-051	5	Yes	No	Yes
Advantage Care by Ultimate (HMO C-SNP)	H2962-052	5	Yes	No	Yes
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-023	5	Yes	No	Yes
Advantage Care COPD by Ultimate (HMO C-SNP)	H2962-025	5	Yes	No	Yes
Advantage Plus by Ultimate (Full) (HMO D-SNP)	H2962-035	5	Yes	No	Yes
Advantage Plus by Ultimate (Partial) (HMO D-SNP)	H2962-036	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-001	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-028	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-045	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-046	5	Yes	No	Yes
Premier by Ultimate (HMO)	H2962-047	5	Yes	No	Yes

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.

Jakafi at other payers

Or see Jakafi 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.