Benefily
Prior authorization required

Does Wellpoint Tennessee, INC. require prior authorization for Rezdiffra?

Wellpoint Tennessee, INC. requires prior authorization for Rezdiffra 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 productPlans coveringRequire prior authStep therapyQty limitStatus
resmetirom 100 MG Oral Tablet [Rezdiffra]26779059 / 9909Prior authorization required
resmetirom 60 MG Oral Tablet [Rezdiffra]26779099 / 9909Prior authorization required
resmetirom 80 MG Oral Tablet [Rezdiffra]26779139 / 9909Prior authorization required

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

Plan-by-plan detail — resmetirom 100 MG Oral Tablet [Rezdiffra]

Rezdiffra has 3 products in the corpus; this table is for resmetirom 100 MG Oral Tablet [Rezdiffra], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellpoint Extra Help (HMO-POS)H5828-0085YesNoYes
Wellpoint Full Dual Advantage (HMO D-SNP)H5828-0025YesNoYes
Wellpoint Full Dual Advantage 2 (HMO D-SNP)H5828-0185YesNoYes
Wellpoint Full Dual Advantage Support (HMO D-SNP)H5828-0015YesNoYes
Wellpoint Medicare Advantage (HMO-POS)H5828-0135YesNoYes
Wellpoint Medicare Advantage 2 (HMO-POS)H5828-0145YesNoYes
Wellpoint Medicare Advantage 2 (HMO-POS)H5828-0155YesNoYes
Wellpoint Medicare Advantage 2 (HMO-POS)H5828-0165YesNoYes
Wellpoint Medicare Advantage 2 (HMO-POS)H5828-0175YesNoYes
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.

Rezdiffra at other payers

Or see Rezdiffra 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.