Benefily
Varies by plan

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

Prior authorization for Recombivax differs across Healthsun Health Plans, INC.'s Medicare Part D plans and product strengths — 3 of 5 Recombivax products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]165815013 / 131300Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]165815513 / 131300Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]83024513 / 131300Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]8302530 / 13000Not on formulary
1 ML hepatitis B surface antigen vaccine 0.04 MG/ML Injection [Recombivax]8302630 / 13000Not on formulary

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

Plan-by-plan detail — 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]

Recombivax has 5 products in the corpus; this table is for 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSun HealthAdvantage Plan (HMO)H5431-0011YesNoNo
HealthSun HealthAdvantage Plan (HMO)H5431-0121YesNoNo
HealthSun HealthAdvantage Plan (HMO)H5431-0131YesNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0171YesNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0181YesNoNo
HealthSun HealthAdvantage Plus (HMO)H5431-0201YesNoNo
HealthSun MediMax (HMO)H5431-0061YesNoNo
HealthSun MediSun Extra (HMO D-SNP)H5431-0191YesNoNo
HealthSun MediSun Full Dual Extra (HMO D-SNP)H5431-0261YesNoNo
HealthSun MediSun Full Dual Plus (HMO D-SNP)H5431-0251YesNoNo
HealthSun MediSun Plus (HMO D-SNP)H5431-0161YesNoNo
HealthSun VitalCare (HMO C-SNP)H5431-0211YesNoNo
HealthSun VitalCare (HMO C-SNP)H5431-0221YesNoNo
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.

Recombivax at other payers

Or see Recombivax 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.