Dermatology
For the dermatologist prescribing psoriasis and eczema biologics — the PA map for every payer and state.
Every state, quantified for dermatology
| State | Approved · CY25 | Rules | PA-required | Appeal | Criteria docs |
|---|---|---|---|---|---|
| ● Recent · CY2025 disclosures — click a state to drill in | |||||
| WAWashington▸ viewing | 88.2% | 36 | 100% | ✓ | 1 |
| COColorado | 91.8% | 32 | 91% | ✓ | 8 |
| OHOhio | 77.7% | 38 | 100% | ✓ | 6 |
| All states · A–Z | |||||
| AKAlaska | — | 23 | 100% | ✓ | 3 |
| ALAlabama | — | 34 | 100% | ✓ | 6 |
| ARArkansas | — | 36 | 100% | ✓ | 3 |
| AZArizona | — | 33 | 100% | ✓ | 3 |
| CACalifornia | — | 38 | 92% | ✓ | 11 |
| CTConnecticut | — | 33 | 100% | ✓ | 2 |
| DCDistrict of Columbia | — | 33 | 91% | ✓ | 6 |
| DEDelaware | — | 32 | 100% | ✓ | 3 |
| FLFlorida | — | 34 | 100% | ✓ | 1 |
| GAGeorgia | — | 36 | 92% | ✓ | 4 |
| HIHawaii | — | 35 | 86% | ✓ | 4 |
| IAIowa | — | 31 | 100% | ✓ | 8 |
| IDIdaho | — | 26 | 100% | ✓ | 2 |
| ILIllinois | — | 33 | 100% | ✓ | 1 |
| INIndiana | — | 31 | 100% | ✓ | 1 |
| KSKansas | — | 34 | 100% | ✓ | 28 |
| KYKentucky | — | 37 | 100% | ✓ | 5 |
| LALouisiana | — | 31 | 100% | ✓ | 9 |
| MAMassachusetts | — | 29 | 100% | ✓ | 1 |
| MDMaryland | — | 29 | 90% | ✓ | 4 |
| MEMaine | — | 30 | 100% | ✓ | 4 |
| MIMichigan | — | 32 | 100% | ✓ | 5 |
| MNMinnesota | — | 26 | 100% | ✓ | 2 |
| MOMissouri | — | 39 | 100% | ✓ | — |
| MSMississippi | — | 36 | 100% | ✓ | 19 |
| MTMontana | — | 24 | 100% | ✓ | 2 |
| NCNorth Carolina | — | 37 | 100% | ✓ | 1 |
| NDNorth Dakota | — | 24 | 100% | ✓ | — |
| NENebraska | — | 30 | 100% | ✓ | 3 |
| NHNew Hampshire | — | 29 | 100% | ✓ | — |
| NJNew Jersey | — | 31 | 100% | ✓ | 4 |
| NMNew Mexico | — | 25 | 100% | ✓ | — |
| NVNevada | — | 30 | 100% | ✓ | 9 |
| NYNew York | — | 34 | 100% | ✓ | 8 |
| OKOklahoma | — | 38 | 100% | ✓ | 2 |
| OROregon | — | 34 | 91% | ✓ | 3 |
| PAPennsylvania | — | 32 | 100% | ✓ | 16 |
| RIRhode Island | — | 24 | 100% | ✓ | — |
| SCSouth Carolina | — | 33 | 100% | ✓ | 3 |
| SDSouth Dakota | — | 22 | 100% | ✓ | — |
| TNTennessee | — | 34 | 100% | ✓ | 3 |
| TXTexas | — | 38 | 100% | ✓ | 26 |
| UTUtah | — | 35 | 100% | ✓ | 14 |
| VAVirginia | — | 35 | 91% | ✓ | 3 |
| VTVermont | — | 22 | 100% | ✓ | 2 |
| WIWisconsin | — | 33 | 100% | ✓ | 2 |
| WVWest Virginia | — | 27 | 100% | ✓ | — |
| WYWyoming | — | 22 | 100% | ✓ | 5 |
Washington — dermatology, every program
Click any state in the table above to drill into its rules, approval rates, and appeal path.
● Rules verified as-of Jun 8, 2026- jak inhibitorsPA required
WA Medicaid PDL: non-preferred agents in this class require PA.
- dermatology biologicsPA required
WA Medicaid PDL: non-preferred agents in this class require PA.
- dermatology biologics(UnitedHealthcare)PA required
UnitedHealthcare commercial (Advantage 3-Tier). Derm biologic/JAK subset within Dermatological heading; all carry PA+QL+SP [e.g. DUPIXENT, ADBRY, CIBINQO, OPZELURA]
- tnf inhibitors(UnitedHealthcare)PA required
UnitedHealthcare commercial (Advantage 3-Tier). TNF inhibitor subset within Immunological heading; all carry PA+QL+SP [e.g. HUMIRA, ENBREL, CIMZIA, SIMPONI]
- il inhibitors biologics(UnitedHealthcare)PA required
UnitedHealthcare commercial (Advantage 3-Tier). IL inhibitor subset within Immunological heading; all carry PA+QL+SP (some +ST) [e.g. COSENTYX, SKYRIZI, BIMZELX, OMVOH]
- jak inhibitors(UnitedHealthcare)PA required
UnitedHealthcare commercial (Advantage 3-Tier). JAK inhibitor subset within Immunological heading; all carry PA+QL+SP [e.g. RINVOQ, XELJANZ, XELJANZ XR, OLUMIANT]
- dermatology biologics(Cigna)PA required
Cigna commercial (Advantage 3-Tier). atopic dermatitis/alopecia biologics+JAKs SP+PA in skin section [e.g. ADBRY, CIBINQO, EBGLYSS, LITFULO]
- tnf inhibitors(Cigna)PA required
Cigna commercial (Advantage 3-Tier). TNF inhibitors SP+PA in pain/inflammatory section [e.g. HUMIRA, ENBREL, INFLECTRA, CIMZIA]
- jak inhibitors(Cigna)PA required
Cigna commercial (Advantage 3-Tier). JAK/TYK2 inhibitors SP+PA [e.g. RINVOQ, XELJANZ, OLUMIANT, SOTYKTU]
- il inhibitors biologics(Cigna)PA required
Cigna commercial (Advantage 3-Tier). IL-17/23/etc biologics SP+PA [e.g. COSENTYX, TALTZ, SKYRIZI, TREMFYA]
- tnf inhibitors(Aetna (CVS Caremark))PA required
Aetna (CVS Caremark) commercial formulary. self-administered autoimmune biologics + JAK (TNF/IL/JAK), specialty PSP, PA/ST [e.g. HUMIRA, ENBREL, DUPIXENT, SKYRIZI]
- il inhibitors biologics(Anthem Blue Cross (Elevance))PA required
Anthem Blue Cross (Elevance) commercial formulary. Interleukin antagonists + costimulation modulators: PA/SP (some ST) [e.g. STELARA, SKYRIZI, ustekinumab, ORENCIA abatacept]
- tnf inhibitors(Anthem Blue Cross (Elevance))PA required
Anthem Blue Cross (Elevance) commercial formulary. Soluble TNF receptor + anti-TNF monoclonals: PA/SP [e.g. ENBREL, HUMIRA, etanercept, adalimumab]
- jak inhibitors(Anthem Blue Cross (Elevance))PA required
Anthem Blue Cross (Elevance) commercial formulary. Antirheumatic JAK + oncology JAK: PA/SP [e.g. RINVOQ, XELJANZ, upadacitinib, JAKAFI ruxolitinib]
- jak inhibitors(Centene)PA required
Centene Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Centene)PA required
Centene Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Centene)PA required
Centene Part D (CMS formulary file, plan-grounded).
- jak inhibitors(Unitedhealthcare)PA required
Unitedhealthcare Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Unitedhealthcare)PA required
Unitedhealthcare Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Unitedhealthcare)PA required
Unitedhealthcare Part D (CMS formulary file, plan-grounded).
- jak inhibitors(Humana)PA required
Humana Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Humana)PA required
Humana Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Humana)PA required
Humana Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Cigna)PA required
Cigna Part D (CMS formulary file, plan-grounded).
- jak inhibitors(Cigna)PA required
Cigna Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Cigna)PA required
Cigna Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Aetna)PA required
Aetna Part D (CMS formulary file, plan-grounded).
- jak inhibitors(Aetna)PA required
Aetna Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Aetna)PA required
Aetna Part D (CMS formulary file, plan-grounded).
- jak inhibitors(Kaiser)PA required
Kaiser Part D (CMS formulary file, plan-grounded).
- tnf inhibitors(Kaiser)PA required
Kaiser Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Kaiser)PA required
Kaiser Part D (CMS formulary file, plan-grounded).
- il inhibitors biologics(Molina Healthcare)PA required
Molina Healthcare commercial formulary. IL-1/IL-1Ra/IL-6/IL-5/anti-IgE and GI IL antagonists all PA
- tnf inhibitors(Molina Healthcare)PA required
Molina Healthcare commercial formulary. Anti-TNF mAbs, soluble TNF receptor, and GI TNF blockers all carry PA
- jak inhibitors(Molina Healthcare)PA required
Molina Healthcare commercial formulary. Antirheumatic JAK inhibitors carry PA (5 flags)
- dermatology biologics(Molina Healthcare)PA required
Molina Healthcare commercial formulary. Antipsoriatics-systemic (incl PYZCHIVA, biologics) carry 18 PA
Full criteria, sources & appeal paths — all 51 states.
You’ve seen the breadth and one state in full. The complete Dermatologypack — every state’s criteria, source citations, and step-by-step appeal instructions — is one email away.
Assembled from Auth57’s rules + criteria corpus + 51-state appeal layer. Draft data — verify against the payer’s current policy before relying.