Does Sanford Health Plan require prior authorization for Fragmin?
Sanford Health Plan 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 0.2 ML dalteparin sodium 12500 UNT/ML Prefilled Syringe [Fragmin]978727 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]978735 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 0.3 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]978737 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 0.5 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]978741 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 0.6 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]978745 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 0.72 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]978747 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| 1 ML dalteparin sodium 10000 UNT/ML Prefilled Syringe [Fragmin]978757 | 9 / 9 | 0 | 0 | 0 | No prior authorization |
| dalteparin sodium 25000 UNT/ML Injectable Solution [Fragmin]978778 | 9 / 9 | 0 | 0 | 0 | No 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.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Align ChoiceElite (PPO) | H8385-001 | 4 | No | No | No |
| Align ChoiceElite (PPO) | H8385-002 | 4 | No | No | No |
| Align ChoicePlus (PPO) | H8385-003 | 4 | No | No | No |
| Align ChoicePlus (PPO) | H8385-004 | 4 | No | No | No |
| Align Dual Partnership (HMO D-SNP) | H8967-003 | 4 | No | No | No |
| Great Plain Medicare Advantage Gold (HMO I-SNP) | H1787-002 | 4 | No | No | No |
| Great Plains Medicare Advantage (HMO I-SNP) | H1787-001 | 4 | No | No | No |
| Great Plains Medicare Advantage (HMO I-SNP) | H8967-001 | 4 | No | No | No |
| Great Plains Medicare Advantage Gold (HMO I-SNP) | H8967-002 | 4 | 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.
Fragmin at other payers
Or see Fragmin across every payer at once.
- Aetna (CVS Health)
- Simply Healthcare Plans, INC.
- Upmc Health Plan, INC.
- Ultimate Health Plans, INC.
- Excellus Health Plan, INC.
- Healthsun Health Plans, INC.
- Upmc Health Network, INC.
- Quartz Health Plan Corporation
- Allina Health And Aetna Insurance Company
- Network Health Insurance Corporation
- Fallon Community Health Plan
- Mass General Brigham Health Plan, INC
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.