XIFAXAN has excellent insurance coverage for patients with overt HE1
The resources below can help you find coverage for some of your adult patients.
Look up coverage for XIFAXAN in your area, make PAs simpler, learn how to avoid denials for appropriate patients, and locate a Low-income Subsidy for appropriate patients for XIFAXAN. When needed, we have an example of a Letter of Medical Necessity and a Tier Exemption Request as well.
Get XIFAXAN coverage by plan in your area
The XIFAXAN Coverage Lookup Tool can help you determine how a patient's prescription drug insurance covers XIFAXAN in your ZIP code.*
Find helpful information if your patient’s plan requires a PA
Simplifying the PA process for XIFAXAN
Being proactive with PAs leads to higher approval rates.1 View the brochure below to see simple directions for submitting a PA for XIFAXAN when needed.
View PA Considerations Brochure
Plus, learn how to avoid common reasons for a denial for appropriate patients by expanding the chart.

Improve the PA process for XIFAXAN with CoverMyMeds
In 2020, PAs had a 90% approval rate for XIFAXAN for OHE when submitted through CoverMyMeds.1 To start a PA for XIFAXAN, you can go to covermymeds.com or call 1-866-452-5017.
Letter of Medical Necessity||
For both commercially and government insured patients, your practice may need to file an appeal if a patient is denied coverage for XIFAXAN. Please fill out and submit a Letter of Medical Necessity on behalf of your patient who has been prescribed XIFAXAN.
View Letter of Medical Necessity example
Low-Income Subsidy Program
Your eligible patients may be entitled to “Extra Help” through the Low-Income Subsidy program.
LIS recipients are entitled to branded prescription drugs at an affordable cost—no more than $9.20/prescription—which is a Medicare Part D benefit.4

Your patient may already be enrolled, however, if they aren’t they can visit here to determine eligibility and apply for benefits.
View Low-income subsidy brochure
View a Tier Exemption request example
*Salix Pharmaceuticals does not guarantee coverage or reimbursement for the product.
†Patient is not eligible if he/she participates in or seeks reimbursement or submits a claim for reimbursement to any federal or state healthcare program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state healthcare program (each a Government Program) or where prohibited by law. Patient must be enrolled in, and must seek reimbursement from or submit a claim for reimbursement to, a commercial insurance plan. Offer excludes full cash-paying patients. Maximum benefits and other restrictions apply. Visit https://xifaxan.copaysavingsprogram.com or call 1-866-XIFAXAN for full eligibility criteria, terms and conditions.
‡Formulary status subject to change.
||NOTE: These sample forms are provided for informational purposes only. As a reminder, it is the responsibility of the HCP and/or their office staff, as appropriate, to determine the correct diagnosis, treatment protocol, and content of all such forms for each individual patient.
Get information regarding XIFAXAN
Speak with a XIFAXAN representative
INDICATIONS
XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.
IMPORTANT SAFETY INFORMATION
- XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
- Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.