Prior authorization required

Does Wellpoint Insurance Company require prior authorization for Xolair?

Wellpoint Insurance Company requires prior authorization for Xolair 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	Qty limit	Status
omalizumab 150 MG Injection [Xolair]1657212	14 / 14	14	14	Prior authorization required
1 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2058946	14 / 14	14	14	Prior authorization required
0.5 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2058950	14 / 14	14	14	Prior authorization required
2 ML omalizumab 150 MG/ML Prefilled Syringe [Xolair]2663918	14 / 14	14	14	Prior authorization required
2 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2663923	14 / 14	14	14	Prior authorization required
1 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2673761	14 / 14	14	14	Prior authorization required
0.5 ML omalizumab 150 MG/ML Auto-Injector [Xolair]2673763	14 / 14	14	14	Prior authorization required

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

Plan-by-plan detail — omalizumab 150 MG Injection [Xolair]

Xolair has 7 products in the corpus; this table is for omalizumab 150 MG Injection [Xolair], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Wellpoint Chronic Care (HMO-POS C-SNP)	H8849-001	5	Yes	No	Yes
Wellpoint Chronic Care (HMO-POS C-SNP)	H8849-003	5	Yes	No	Yes
Wellpoint Dual Advantage (HMO D-SNP)	H8849-011	5	Yes	No	Yes
Wellpoint Dual Advantage (HMO D-SNP)	H8849-011	5	Yes	No	Yes
Wellpoint Dual Advantage (HMO D-SNP)	H8849-011	5	Yes	No	Yes
Wellpoint Dual Advantage (HMO D-SNP)	H8849-011	5	Yes	No	Yes
Wellpoint Dual Advantage (HMO D-SNP)	H8849-011	5	Yes	No	Yes
Wellpoint Full Dual Advantage (HMO D-SNP)	H8849-010	5	Yes	No	Yes
Wellpoint Full Dual Advantage (HMO D-SNP)	H8849-010	5	Yes	No	Yes
Wellpoint Full Dual Advantage (HMO D-SNP)	H8849-010	5	Yes	No	Yes
Wellpoint Full Dual Advantage (HMO D-SNP)	H8849-010	5	Yes	No	Yes
Wellpoint Lung Care (HMO-POS C-SNP)	H8849-005	5	Yes	No	Yes
Wellpoint Select (HMO-POS)	H8849-006	5	Yes	No	Yes
Wellpoint Select (HMO-POS)	H8849-009	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.

Xolair at other payers

Or see Xolair 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.