Benefily
Prior authorization required

Does Alignment Healthcare require prior authorization for Tenivac?

Alignment Healthcare requires prior authorization for Tenivac 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
0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac]119091667 / 676700Prior authorization required
0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Prefilled Syringe [Tenivac]119091967 / 676700Prior authorization required

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

Plan-by-plan detail — 0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac]

Tenivac has 2 products in the corpus; this table is for 0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Alignment Health + Intermountain Health (HMO)H9686-0091YesNoNo
Alignment Health Advantage PPO (PPO)H8832-0011YesNoNo
Alignment Health Advantage PPO (PPO)H8832-0021YesNoNo
Alignment Health AllCare Preferred (HMO)H3815-0111YesNoNo
Alignment Health AVA (PPO)H7074-0011YesNoNo
Alignment Health Balance (HMO C-SNP)H3815-0331YesNoNo
Alignment Health Balance (PPO)H4961-0061YesNoNo
Alignment Health BreathEasy (HMO C-SNP)H3815-0411YesNoNo
Alignment Health Clarity (HMO C-SNP)H3815-0421YesNoNo
Alignment Health CommUnity (HMO)H3815-0461YesNoNo
Alignment Health Dual Select+ (HMO-POS D-SNP)H5472-0071YesNoNo
Alignment Health Freedom (PPO)H8832-0031YesNoNo
Alignment Health Harmony (HMO)H3815-0311YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H3443-0031YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H3815-0101YesNoNo
Alignment Health Heart & Diabetes (HMO C-SNP)H9686-0041YesNoNo
Alignment Health Heart & Diabetes (HMO-POS C-SNP)H5472-0021YesNoNo
Alignment Health Heart & Diabetes Access (HMO C-SNP)H3815-0441YesNoNo
Alignment Health Heart & Diabetes AZPlus (HMO C-SNP)H3443-0071YesNoNo
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)H3815-0391YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0481YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0541YesNoNo
Alignment Health Heart & Diabetes Care (HMO C-SNP)H5296-0111YesNoNo
Alignment Health Heart & Diabetes Choice (HMO C-SNP)H3815-0511YesNoNo
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)H5296-0091YesNoNo
Alignment Health Heart & Diabetes NVPlus (HMO C-SNP)H9686-0061YesNoNo
Alignment Health Heart & Diabetes Plus (HMO C-SNP)H3443-0061YesNoNo
Alignment Health Heart & Diabetes Plus (HMO-POS C-SNP)H5472-0041YesNoNo
Alignment Health Honor+ Plan (HMO)H3815-0521YesNoNo
Alignment Health L.A. Premium Giveback (HMO)H3815-0551YesNoNo
Alignment Health My Choice (HMO)H3815-0011YesNoNo
Alignment Health My Choice (HMO)H3815-0281YesNoNo
Alignment Health My Choice (PPO)H4961-0011YesNoNo
Alignment Health My Choice (PPO)H4961-0031YesNoNo
Alignment Health My Choice CalCare (HMO)H3815-0501YesNoNo
Alignment Health My Choice Select (HMO)H3815-0491YesNoNo
Alignment Health NC Duals (HMO-POS D-SNP)H5296-0041YesNoNo
Alignment Health Platinum (HMO)H5296-0031YesNoNo
Alignment Health Platinum + Instacart (HMO-POS)H3815-0161YesNoNo
Alignment Health Platinum + Instacart (HMO)H3815-0081YesNoNo
Alignment Health Platinum + Instacart (HMO)H5296-0071YesNoNo
Alignment Health Platinum + Instacart (HMO)H9686-0071YesNoNo
Alignment Health Platinum Select (HMO)H5296-0101YesNoNo
Alignment Health S.D. Premium Giveback (HMO)H3815-0561YesNoNo
Alignment Health Silicon (HMO C-SNP)H3815-0451YesNoNo
Alignment Health smartHMO (HMO-POS)H5472-0031YesNoNo
Alignment Health smartHMO (HMO)H3443-0051YesNoNo
Alignment Health smartHMO (HMO)H3815-0131YesNoNo
Alignment Health smartHMO (HMO)H3815-0381YesNoNo
Alignment Health smartHMO (HMO)H3815-0401YesNoNo
Alignment Health smartHMO (HMO)H5296-0061YesNoNo
Alignment Health smartHMO (HMO)H5296-0081YesNoNo
Alignment Health smartHMO (HMO)H9686-0081YesNoNo
Alignment Health smartSavings (HMO-POS)H5472-0101YesNoNo
Alignment Health smartSavings (HMO)H3815-0471YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0191YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0201YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0211YesNoNo
Alignment Health Sutter Advantage +More (HMO)H3815-0231YesNoNo
Alignment Health the ONE (HMO D-SNP)H9686-0051YesNoNo
Alignment Health the ONE (HMO)H3815-0341YesNoNo
Alignment Health the ONE + Walgreens (HMO-POS)H5472-0011YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3443-0011YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3443-0021YesNoNo
Alignment Health the ONE + Walgreens (HMO)H3815-0351YesNoNo
Alignment Health Total Dual+ (HMO-POS D-SNP)H5472-0091YesNoNo
Alignment Health ValorCare (HMO)H3815-0531YesNoNo
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.

Tenivac at other payers

Or see Tenivac 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.