Benefily
No prior authorization

Does Health Care Service Corporation require prior authorization for Quadracel?

Health Care Service Corporation 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]258705731 / 31000No 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]259312131 / 31000No 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
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP)H8634-0091NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H8634-0311NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0011NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0021NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0121NoNoNo
Blue Cross Medicare Advantage Basic Plus (HMO-POS)H3822-0071NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H0107-0051NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H8634-0031NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H8634-0041NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H0107-0031NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0081NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0101NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0221NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0271NoNoNo
Blue Cross Medicare Advantage Complete (PPO)H8634-0231NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H0107-0071NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0211NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0241NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0291NoNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H3251-0291NoNoNo
Blue Cross Medicare Advantage Essential (PPO)H8634-0121NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H0107-0101NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0181NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0251NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0301NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H0107-0041NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H8634-0321NoNoNo
Blue Cross Medicare Advantage Preferred (PPO)H8634-0331NoNoNo
Blue Cross Medicare Advantage Premier Plus (HMO-POS)H3822-0081NoNoNo
Blue Cross Medicare Advantage Select (HMO)H3251-0021NoNoNo
Blue Cross Medicare Advantage Value (HMO)H3822-0141NoNoNo
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.