Does Freedom Health, INC. require prior authorization for Quadracel?
Freedom Health, INC. 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 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]2587057 | 24 / 24 | 0 | 0 | 0 | No 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]2593121 | 24 / 24 | 0 | 0 | 0 | No 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.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Freedom Medi-Medi Full (HMO D-SNP) | H5427-087 | 1 | No | No | No |
| Freedom Medi-Medi Partial (HMO D-SNP) | H5427-078 | 1 | No | No | No |
| Freedom Medicare Plan Rx (HMO) | H5427-059 | 1 | No | No | No |
| Freedom Medicare Plan Rx (HMO) | H5427-060 | 1 | No | No | No |
| Freedom M�ximo (HMO-POS) | H5427-112 | 1 | No | No | No |
| Freedom M�ximo (HMO-POS) | H5427-113 | 1 | No | No | No |
| Freedom Platinum Plan Rx (HMO) | H5427-088 | 1 | No | No | No |
| Freedom Platinum Plan Rx (HMO) | H5427-089 | 1 | No | No | No |
| Freedom Platinum Plan Rx (HMO) | H5427-091 | 1 | No | No | No |
| Freedom Platinum Plan Rx (HMO) | H5427-093 | 1 | No | No | No |
| Freedom Platinum Plan Rx (HMO) | H5427-094 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-096 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-102 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-103 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-105 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-106 | 1 | No | No | No |
| Freedom Platinum Rewards Plan Rx (HMO) | H5427-107 | 1 | No | No | No |
| Freedom VIP Care (HMO C-SNP) | H5427-070 | 1 | No | No | No |
| Freedom VIP Rewards (HMO C-SNP) | H5427-099 | 1 | No | No | No |
| Freedom VIP Rewards (HMO C-SNP) | H5427-108 | 1 | No | No | No |
| Freedom VIP Savings (HMO C-SNP) | H5427-072 | 1 | No | No | No |
| Freedom VIP Savings (HMO C-SNP) | H5427-082 | 1 | No | No | No |
| Freedom VIP Savings COPD (HMO C-SNP) | H5427-077 | 1 | No | No | No |
| Freedom VIP Savings COPD (HMO C-SNP) | H5427-083 | 1 | No | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
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Quadracel at other payers
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.