Does Preferred Care Network, INC. require prior authorization for Recombivax?
Preferred Care Network, INC. requires prior authorization for Recombivax on every Medicare Part D plan of theirs that covers it.
Every plan from this payer that covers the drug requires authorization before it is dispensed.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]1658150 | 6 / 6 | 6 | 0 | 6 | Prior authorization required |
| 0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]1658155 | 6 / 6 | 6 | 0 | 6 | Prior authorization required |
| 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]830245 | 6 / 6 | 6 | 0 | 6 | Prior authorization required |
| 0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]830253 | 6 / 6 | 6 | 0 | 6 | Prior authorization required |
| 1 ML hepatitis B surface antigen vaccine 0.04 MG/ML Injection [Recombivax]830263 | 6 / 6 | 6 | 0 | 6 | Prior authorization required |
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.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| UHC MedicareMax Complete Care FL-30 (HMO C-SNP) | H5420-014 | 3 | Yes | No | Yes |
| UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) | H5420-006 | 3 | Yes | No | Yes |
| UHC MedicareMax Dual Complete FL-V3 (HMO D-SNP) | H5420-015 | 3 | Yes | No | Yes |
| UHC MedicareMax Dual Complete FL-Y6 (HMO-POS D-SNP) | H5420-016 | 3 | Yes | No | Yes |
| UHC MedicareMax Medicare Advantage FL-0028 (HMO) | H5420-001 | 3 | Yes | No | Yes |
| UHC MedicareMax Medicare Advantage FL-0029 (HMO) | H5420-003 | 3 | Yes | No | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Recombivax 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.