Benefily
Prior authorization required

Does Hcsc Insurance Services Company require prior authorization for Tenivac?

Hcsc Insurance Services Company requires prior authorization for Tenivac on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac]119091618 / 181800Prior authorization required
0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Prefilled Syringe [Tenivac]119091918 / 181800Prior authorization required

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

Plan-by-plan detail — 0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac]

Tenivac has 2 products in the corpus; this table is for 0.5 ML diphtheria toxoid vaccine, inactivated 4 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Tenivac], the one carried on the most plans. The product table above covers every strength.

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

Tenivac at other payers

Or see Tenivac 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.