Does Pacificsource Community Health Plans require prior authorization for YF-Vax?
Pacificsource Community Health Plans does not require prior authorization for YF-Vax 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 |
|---|---|---|---|---|---|
| yellow fever virus strain 17D-204 live antigen 4000 UNT/ML Injectable Suspension [YF-Vax]1292828 | 11 / 11 | 0 | 0 | 0 | No prior authorization |
| 0.5 ML yellow fever virus strain 17D-204 live antigen 4000 UNT/ML Injection [YF-Vax]1658241 | 11 / 11 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — yellow fever virus strain 17D-204 live antigen 4000 UNT/ML Injectable Suspension [YF-Vax]
YF-Vax has 2 products in the corpus; this table is for yellow fever virus strain 17D-204 live antigen 4000 UNT/ML Injectable Suspension [YF-Vax], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| PacificSource Dual Care (HMO D-SNP) | H3864-043 | 3 | No | No | No |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | H3864-014 | 3 | No | No | No |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | H3864-036 | 3 | No | No | No |
| PacificSource Medicare Essentials Rx 27 (HMO) | H3864-027 | 3 | No | No | No |
| PacificSource Medicare Essentials Rx 41 (HMO) | H3864-041 | 3 | No | No | No |
| PacificSource Medicare Essentials Rx 6 (HMO) | H3864-006 | 3 | No | No | No |
| PacificSource Medicare Explorer Rx 4 (PPO) | H4754-004 | 3 | No | No | No |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | H3864-024 | 3 | No | No | No |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | H3864-029 | 3 | No | No | No |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | H3864-034 | 3 | No | No | No |
| PacificSource Medicare MyCare Rx 40 (HMO) | H3864-040 | 3 | No | No | No |
- 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.
YF-Vax 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.