Benefily
No prior authorization

Does Bravo Health Pennsylvania, INC. require prior authorization for Gardasil 9?

Bravo Health Pennsylvania, INC. does not require prior authorization for Gardasil 9 on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
0.5 ML L1 protein, human papillomavirus type 11 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 16 vaccine 0.12 MG/ML / L1 protein, human papillomavirus type 18 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 31 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 33 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 45 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 52 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 58 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 6 vaccine 0.06 MG/ML Injection [Gardasil 9]159709935 / 35000No prior authorization
0.5 ML L1 protein, human papillomavirus type 11 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 16 vaccine 0.12 MG/ML / L1 protein, human papillomavirus type 18 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 31 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 33 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 45 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 52 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 58 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 6 vaccine 0.06 MG/ML Prefilled Syringe [Gardasil 9]159710335 / 35000No prior authorization

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

Plan-by-plan detail — 0.5 ML L1 protein, human papillomavirus type 11 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 16 vaccine 0.12 MG/ML / L1 protein, human papillomavirus type 18 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 31 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 33 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 45 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 52 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 58 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 6 vaccine 0.06 MG/ML Injection [Gardasil 9]

Gardasil 9 has 2 products in the corpus; this table is for 0.5 ML L1 protein, human papillomavirus type 11 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 16 vaccine 0.12 MG/ML / L1 protein, human papillomavirus type 18 vaccine 0.08 MG/ML / L1 protein, human papillomavirus type 31 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 33 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 45 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 52 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 58 vaccine 0.04 MG/ML / L1 protein, human papillomavirus type 6 vaccine 0.06 MG/ML Injection [Gardasil 9], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSpring Achieve (HMO C-SNP)H0354-0273NoNoNo
HealthSpring Achieve (HMO C-SNP)H3949-0243NoNoNo
HealthSpring Alliance (HMO)H0354-0283NoNoNo
HealthSpring Preferred (HMO)H0354-0013NoNoNo
HealthSpring Preferred (HMO)H3949-0353NoNoNo
HealthSpring Preferred (HMO)H3949-0453NoNoNo
HealthSpring Preferred (HMO)H3949-0473NoNoNo
HealthSpring Preferred (HMO)H3949-0493NoNoNo
HealthSpring Preferred (HMO)H3949-0523NoNoNo
HealthSpring Preferred (HMO)H3949-0543NoNoNo
HealthSpring Preferred (HMO)H9725-0093NoNoNo
HealthSpring Preferred (HMO)H9725-0093NoNoNo
HealthSpring Preferred (HMO)H9725-0093NoNoNo
HealthSpring Preferred (HMO)H9725-0093NoNoNo
HealthSpring Preferred Full Savings (HMO)H0354-0303NoNoNo
HealthSpring Preferred PA (HMO)H3949-0313NoNoNo
HealthSpring Preferred Plus (HMO)H3949-0303NoNoNo
HealthSpring Preferred Plus (HMO)H3949-0483NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0173NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0173NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0173NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0173NoNoNo
HealthSpring Preferred Savings (HMO)H0354-0293NoNoNo
HealthSpring Preferred Savings (HMO)H3949-0533NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0153NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0153NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0153NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0153NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0163NoNoNo
HealthSpring Preferred Select (HMO)H9725-0143NoNoNo
HealthSpring Premier (HMO-POS)H9725-0183NoNoNo
HealthSpring TotalCare (HMO D-SNP)H9725-0033NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H2752-0033NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H3949-0093NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H9725-0133NoNoNo
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.

Gardasil 9 at other payers

Or see Gardasil 9 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.