Benefily
No prior authorization

Does Healthsun Health Plans, INC. require prior authorization for Fragmin?

Healthsun Health Plans, INC. does not require prior authorization for Fragmin 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
0.2 ML dalteparin sodium 12500 UNT/ML Prefilled Syringe [Fragmin]97872713 / 13000No prior authorization
0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]97873513 / 13000No prior authorization
0.3 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]97873713 / 13000No prior authorization
0.5 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]97874113 / 13000No prior authorization
0.6 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]97874513 / 13000No prior authorization
0.72 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]97874713 / 13000No prior authorization
1 ML dalteparin sodium 10000 UNT/ML Prefilled Syringe [Fragmin]97875713 / 13000No prior authorization
dalteparin sodium 25000 UNT/ML Injectable Solution [Fragmin]97877813 / 13000No prior authorization

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

Plan-by-plan detail — 0.2 ML dalteparin sodium 12500 UNT/ML Prefilled Syringe [Fragmin]

Fragmin has 8 products in the corpus; this table is for 0.2 ML dalteparin sodium 12500 UNT/ML Prefilled Syringe [Fragmin], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSun HealthAdvantage Plan (HMO)H5431-0014NoNoNo
HealthSun HealthAdvantage Plan (HMO)H5431-0124NoNoNo
HealthSun HealthAdvantage Plan (HMO)H5431-0134NoNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0174NoNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0184NoNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0204NoNoNo
HealthSun MediMax (HMO)H5431-0064NoNoNo
HealthSun MediSun Extra (HMO D-SNP)H5431-0194NoNoNo
HealthSun MediSun Full Dual Extra (HMO D-SNP)H5431-0264NoNoNo
HealthSun MediSun Full Dual Plus (HMO D-SNP)H5431-0254NoNoNo
HealthSun MediSun Plus (HMO D-SNP)H5431-0164NoNoNo
HealthSun VitalCare (HMO C-SNP)H5431-0214NoNoNo
HealthSun VitalCare (HMO C-SNP)H5431-0224NoNoNo
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.

Fragmin at other payers

Or see Fragmin 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.