Does Medica Insurance Company require prior authorization for Shingrix?
Medica Insurance Company does not require prior authorization for Shingrix 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 0.5 ML varicella zoster virus glycoprotein E, recombinant 0.1 MG/ML Injection [Shingrix]1986830 | 7 / 7 | 0 | 0 | 7 | No prior authorization |
| 0.5 ML varicella zoster virus glycoprotein E, recombinant 0.1 MG/ML Prefilled Syringe [Shingrix]2719778 | 7 / 7 | 0 | 0 | 7 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 0.5 ML varicella zoster virus glycoprotein E, recombinant 0.1 MG/ML Injection [Shingrix]
Shingrix has 2 products in the corpus; this table is for 0.5 ML varicella zoster virus glycoprotein E, recombinant 0.1 MG/ML Injection [Shingrix], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Medica Prime Solution Basic w/Rx (Cost) | H2450-016 | 1 | No | No | Yes |
| Medica Prime Solution Core w/Rx (Cost) | H2450-035 | 1 | No | No | Yes |
| Medica Prime Solution Enhanced w/Rx 2 (Cost) | H2450-002 | 1 | No | No | Yes |
| Medica Prime Solution Focus w/Rx (Cost) | H2450-039 | 1 | No | No | Yes |
| Medica Prime Solution Premier w/Rx (Cost) | H2450-037 | 1 | No | No | Yes |
| Medica Prime Solution Standard w/Rx (Cost) | H2450-049 | 1 | No | No | Yes |
| Medica Prime Solution Thrift w/Rx (Cost) | H2450-007 | 1 | No | No | Yes |
- 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.
Shingrix at other payers
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.