Benefily
No prior authorization

Does Cigna require prior authorization for Quadracel?

Cigna does not require prior authorization for Quadracel 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 Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel]2587057171 / 171000No prior authorization
0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Prefilled Syringe [Quadracel]2593121171 / 171000No prior authorization

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

Plan-by-plan detail — 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel]

Quadracel has 2 products in the corpus; this table is for 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSpring Achieve (HMO C-SNP)H4407-0343NoNoNo
HealthSpring Achieve (HMO C-SNP)H4513-0943NoNoNo
HealthSpring Achieve (HMO C-SNP)H4513-0973NoNoNo
HealthSpring Achieve (HMO C-SNP)H4513-0983NoNoNo
HealthSpring Alliance (HMO)H4513-0643NoNoNo
HealthSpring Preferred (HMO)H0439-0083NoNoNo
HealthSpring Preferred (HMO)H0439-0093NoNoNo
HealthSpring Preferred (HMO)H0439-0103NoNoNo
HealthSpring Preferred (HMO)H0439-0113NoNoNo
HealthSpring Preferred (HMO)H0439-0133NoNoNo
HealthSpring Preferred (HMO)H0439-0153NoNoNo
HealthSpring Preferred (HMO)H0439-0153NoNoNo
HealthSpring Preferred (HMO)H0439-0203NoNoNo
HealthSpring Preferred (HMO)H0672-0053NoNoNo
HealthSpring Preferred (HMO)H0672-0063NoNoNo
HealthSpring Preferred (HMO)H0672-0133NoNoNo
HealthSpring Preferred (HMO)H0672-0243NoNoNo
HealthSpring Preferred (HMO)H4407-0303NoNoNo
HealthSpring Preferred (HMO)H4407-0303NoNoNo
HealthSpring Preferred (HMO)H4407-0303NoNoNo
HealthSpring Preferred (HMO)H4407-0333NoNoNo
HealthSpring Preferred (HMO)H4407-0353NoNoNo
HealthSpring Preferred (HMO)H4513-0263NoNoNo
HealthSpring Preferred (HMO)H4513-0303NoNoNo
HealthSpring Preferred (HMO)H4513-0373NoNoNo
HealthSpring Preferred (HMO)H4513-0383NoNoNo
HealthSpring Preferred (HMO)H4513-0493NoNoNo
HealthSpring Preferred (HMO)H4513-0493NoNoNo
HealthSpring Preferred (HMO)H4513-0493NoNoNo
HealthSpring Preferred (HMO)H4513-0493NoNoNo
HealthSpring Preferred (HMO)H4513-0493NoNoNo
HealthSpring Preferred (HMO)H4513-0503NoNoNo
HealthSpring Preferred (HMO)H4513-0523NoNoNo
HealthSpring Preferred (HMO)H4513-0613NoNoNo
HealthSpring Preferred (HMO)H4513-0613NoNoNo
HealthSpring Preferred (HMO)H4513-0613NoNoNo
HealthSpring Preferred (HMO)H4513-0613NoNoNo
HealthSpring Preferred (HMO)H4513-0613NoNoNo
HealthSpring Preferred (HMO)H4513-0743NoNoNo
HealthSpring Preferred (HMO)H4513-0773NoNoNo
HealthSpring Preferred (HMO)H4513-0773NoNoNo
HealthSpring Preferred (HMO)H4513-0773NoNoNo
HealthSpring Preferred (HMO)H4513-0773NoNoNo
HealthSpring Preferred (HMO)H4513-0853NoNoNo
HealthSpring Preferred (HMO)H5410-0183NoNoNo
HealthSpring Preferred (HMO)H5410-0243NoNoNo
HealthSpring Preferred (HMO)H5410-0593NoNoNo
HealthSpring Preferred (HMO)H5410-0603NoNoNo
HealthSpring Preferred (HMO)H7020-0113NoNoNo
HealthSpring Preferred (HMO)H7020-0113NoNoNo
HealthSpring Preferred (HMO)H7020-0113NoNoNo
HealthSpring Preferred (HMO)H9460-0013NoNoNo
HealthSpring Preferred AL (HMO)H4513-0463NoNoNo
HealthSpring Preferred AL (HMO)H4513-0463NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0883NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0893NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0903NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0913NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0923NoNoNo
HealthSpring Preferred Full Savings (HMO)H4513-0933NoNoNo
HealthSpring Preferred GA (HMO)H0439-0033NoNoNo
HealthSpring Preferred GA (HMO)H0439-0033NoNoNo
HealthSpring Preferred Plus (HMO)H0439-0063NoNoNo
HealthSpring Preferred Plus (HMO)H4407-0273NoNoNo
HealthSpring Preferred Plus (HMO)H4513-0873NoNoNo
HealthSpring Preferred Plus (HMO)H4513-0873NoNoNo
HealthSpring Preferred Plus (HMO)H4513-0873NoNoNo
HealthSpring Preferred Plus (HMO)H4513-0873NoNoNo
HealthSpring Preferred Savings (HMO)H0439-0163NoNoNo
HealthSpring Preferred Savings (HMO)H0439-0173NoNoNo
HealthSpring Preferred Savings (HMO)H0439-0183NoNoNo
HealthSpring Preferred Savings (HMO)H0439-0193NoNoNo
HealthSpring Preferred Savings (HMO)H0439-0213NoNoNo
HealthSpring Preferred Savings (HMO)H0672-0163NoNoNo
HealthSpring Preferred Savings (HMO)H0672-0173NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0683NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0683NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0683NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0733NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0833NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0863NoNoNo
HealthSpring Preferred Savings (HMO)H4513-0953NoNoNo
HealthSpring Preferred Savings (HMO)H5410-0263NoNoNo
HealthSpring Preferred Savings (HMO)H7020-0103NoNoNo
HealthSpring Preferred Savings (HMO)H7020-0103NoNoNo
HealthSpring Preferred Savings (HMO)H7020-0103NoNoNo
HealthSpring Preferred Savings (HMO)H9460-0033NoNoNo
HealthSpring Premier (HMO-POS)H0439-0243NoNoNo
HealthSpring Premier (HMO-POS)H4513-0363NoNoNo
HealthSpring Premier (HMO-POS)H4513-0843NoNoNo
HealthSpring Premier (HMO-POS)H4513-0963NoNoNo
HealthSpring Primary (HMO)H4513-0353NoNoNo
HealthSpring Primary (HMO)H4513-0533NoNoNo
HealthSpring TotalCare (HMO D-SNP)H0439-0023NoNoNo
Showing 100 of 171 covering plans.
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.

Quadracel at other payers

Or see Quadracel 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.