Does Wellpoint Tennessee, INC. require prior authorization for Xtandi?
Wellpoint Tennessee, INC. requires prior authorization for Xtandi 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 |
|---|---|---|---|---|---|
| enzalutamide 40 MG Oral Capsule [Xtandi]1307309 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| enzalutamide 40 MG Oral Tablet [Xtandi]2390646 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
| enzalutamide 80 MG Oral Tablet [Xtandi]2390650 | 9 / 9 | 9 | 0 | 9 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — enzalutamide 40 MG Oral Capsule [Xtandi]
Xtandi has 3 products in the corpus; this table is for enzalutamide 40 MG Oral Capsule [Xtandi], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Wellpoint Extra Help (HMO-POS) | H5828-008 | 5 | Yes | No | Yes |
| Wellpoint Full Dual Advantage (HMO D-SNP) | H5828-002 | 5 | Yes | No | Yes |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | H5828-018 | 5 | Yes | No | Yes |
| Wellpoint Full Dual Advantage Support (HMO D-SNP) | H5828-001 | 5 | Yes | No | Yes |
| Wellpoint Medicare Advantage (HMO-POS) | H5828-013 | 5 | Yes | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H5828-014 | 5 | Yes | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H5828-015 | 5 | Yes | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H5828-016 | 5 | Yes | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H5828-017 | 5 | Yes | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Xtandi 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.