Benefily
No prior authorization

Does Doctors Healthcare Plans, INC. require prior authorization for Ticovac?

Doctors Healthcare Plans, INC. does not require prior authorization for Ticovac 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
0.25 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac]25836479 / 9000No prior authorization
0.5 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac]25836509 / 9000No prior authorization

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

Plan-by-plan detail — 0.25 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac]

Ticovac has 2 products in the corpus; this table is for 0.25 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
DrElite-SFL (HMO)H4140-0192NoNoNo
DrExtraCare (HMO C-SNP)H4140-0042NoNoNo
DrFlex (HMO D-SNP)H4140-0132NoNoNo
DrMax (HMO)H4140-0012NoNoNo
DrPlatinum-CFL (HMO D-SNP)H4140-0172NoNoNo
DrPlus (HMO D-SNP)H4140-0022NoNoNo
DrSelect (HMO)H4140-0122NoNoNo
DrSelect-CFL (HMO)H4140-0162NoNoNo
DrTotalCare-CFL (HMO C-SNP)H4140-0182NoNoNo
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.

Ticovac at other payers

Or see Ticovac 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.