Benefily
Varies by plan

Does Selecthealth, INC. require prior authorization for Recombivax?

Prior authorization for Recombivax differs across Selecthealth, INC.'s Medicare Part D plans and product strengths — 4 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]165815014 / 141400Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]165815514 / 141400Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]83024514 / 141400Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]83025314 / 141400Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.04 MG/ML Injection [Recombivax]8302630 / 14000Not 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
Select Health Medicare + Kroger (HMO)H1994-0213YesNoNo
Select Health Medicare + Kroger (HMO)H1994-0223YesNoNo
Select Health Medicare + Kroger (HMO)H1994-0303YesNoNo
Select Health Medicare + Kroger (HMO)H1994-0343YesNoNo
Select Health Medicare Active (HMO)H1994-0353YesNoNo
Select Health Medicare Dual (HMO D-SNP)H1994-0153YesNoNo
Select Health Medicare Dual (HMO D-SNP)H1994-0403YesNoNo
Select Health Medicare Essential (HMO)H1994-0013YesNoNo
Select Health Medicare Essential (HMO)H1994-0123YesNoNo
Select Health Medicare Essential (HMO)H1994-0173YesNoNo
Select Health Medicare Essential (HMO)H1994-0273YesNoNo
Select Health Medicare Essential (HMO)H1994-0293YesNoNo
Select Health Medicare Flex (HMO)H1994-0313YesNoNo
Select Health Medicare Wellness (HMO)H1994-0443YesNoNo
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.