Benefily
No prior authorization

Does Hcsc Insurance Services Company require prior authorization for Rotarix?

Hcsc Insurance Services Company does not require prior authorization for Rotarix 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
rotavirus vaccine, live attenuated, G1P[8] human 89-12 strain 667000 UNT/ML Oral Suspension [Rotarix]262782518 / 18000No prior authorization

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

Plan-by-plan detail — rotavirus vaccine, live attenuated, G1P[8] human 89-12 strain 667000 UNT/ML Oral Suspension [Rotarix]

PlanContractTierPrior authStep therapyQty limit
Blue Cross Medicare Advantage Access (PPO)H1666-0211NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0191NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0231NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0061NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0081NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0031NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0121NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H1666-0161NoNoNo
Blue Cross Medicare Advantage Dental Value (HMO)H9706-0071NoNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H9706-0021NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H1666-0141NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0201NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0221NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0241NoNoNo
Blue Cross Medicare Advantage Saver (HMO)H9706-0081NoNoNo
Blue Cross Medicare Advantage Secure (HMO)H9706-0051NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0011NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0091NoNoNo
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.

Rotarix at other payers

Or see Rotarix 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.