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Xeljanz
Tufts Health Plan
Tufts Health Plan Coverage for Xeljanz
All
5
Commercial
2
Health Exchange
1
Managed Medicaid
1
Medicare
1
Commercial
Commercial - HMO
PA Required
Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
Step Therapy
Quantity Limit
See Details
Health Exchange
Health Exchange - HMO - Health Insurance Exchange
PA Required
Step Therapy
Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
Step Therapy
Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
PA Required
Step Therapy
Quantity Limit
See Details
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