Benefily
No prior authorization

Does Vista Health Plan, INC. require prior authorization for Jantoven?

Vista Health Plan, INC. does not require prior authorization for Jantoven on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • 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
warfarin sodium 1 MG Oral Tablet [Jantoven]8552922 / 2000No prior authorization
warfarin sodium 10 MG Oral Tablet [Jantoven]8553002 / 2000No prior authorization
warfarin sodium 2 MG Oral Tablet [Jantoven]8553062 / 2000No prior authorization
warfarin sodium 2.5 MG Oral Tablet [Jantoven]8553160 / 2000Not on formulary
warfarin sodium 3 MG Oral Tablet [Jantoven]8553220 / 2000Not on formulary
warfarin sodium 4 MG Oral Tablet [Jantoven]8553280 / 2000Not on formulary
warfarin sodium 5 MG Oral Tablet [Jantoven]8553360 / 2000Not on formulary
warfarin sodium 6 MG Oral Tablet [Jantoven]8553420 / 2000Not on formulary
warfarin sodium 7.5 MG Oral Tablet [Jantoven]8553480 / 2000Not on formulary

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

Plan-by-plan detail — warfarin sodium 1 MG Oral Tablet [Jantoven]

Jantoven has 9 products in the corpus; this table is for warfarin sodium 1 MG Oral Tablet [Jantoven], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
AmeriHealth Caritas VIP Care (HMO D-SNP)H4227-0021NoNoNo
Keystone First VIP Choice (HMO D-SNP)H4227-0011NoNoNo
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.

Jantoven at other payers

Or see Jantoven 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.