Benefily
Prior authorization required

Does Simply Healthcare Plans, INC. require prior authorization for Engerix-B?

Simply Healthcare Plans, INC. requires prior authorization for Engerix-B 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 productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Injection [Engerix-B]165815750 / 505000Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B]79842850 / 505000Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B]79843050 / 505000Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Injection [Engerix-B]

Engerix-B has 3 products in the corpus; this table is for 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Injection [Engerix-B], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Simply Complete (HMO D-SNP)H5471-0641YesNoNo
Simply Complete (HMO D-SNP)H5471-0661YesNoNo
Simply Complete (HMO D-SNP)H5471-0721YesNoNo
Simply Complete (HMO D-SNP)H5471-0761YesNoNo
Simply Complete (HMO D-SNP)H5471-0821YesNoNo
Simply Complete (HMO D-SNP)H5471-0841YesNoNo
Simply Complete (HMO D-SNP)H5471-1111YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1151YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1181YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1211YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1251YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1381YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1401YesNoNo
Simply Complete Platinum (HMO D-SNP)H5471-1421YesNoNo
Simply Extra (HMO)H5471-1121YesNoNo
Simply Extra Platinum (HMO)H5471-1131YesNoNo
Simply Extra Platinum (HMO)H5471-1171YesNoNo
Simply Extra Platinum (HMO)H5471-1201YesNoNo
Simply Extra Platinum (HMO)H5471-1231YesNoNo
Simply Integrated (HMO D-SNP)H5471-1271YesNoNo
Simply Integrated (HMO D-SNP)H5471-1281YesNoNo
Simply Integrated (HMO D-SNP)H5471-1291YesNoNo
Simply Integrated (HMO D-SNP)H5471-1301YesNoNo
Simply Integrated (HMO D-SNP)H5471-1311YesNoNo
Simply Integrated (HMO D-SNP)H5471-1321YesNoNo
Simply Integrated (HMO D-SNP)H5471-1331YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1341YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1351YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1361YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1371YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1391YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1411YesNoNo
Simply Integrated Platinum (HMO D-SNP)H5471-1431YesNoNo
Simply Level (HMO C-SNP)H5471-0691YesNoNo
Simply Level (HMO C-SNP)H5471-0701YesNoNo
Simply Level (HMO C-SNP)H5471-0731YesNoNo
Simply Level (HMO C-SNP)H5471-0751YesNoNo
Simply Level (HMO C-SNP)H5471-0801YesNoNo
Simply Level Platinum (HMO C-SNP)H5471-1161YesNoNo
Simply Level Platinum (HMO C-SNP)H5471-1191YesNoNo
Simply Level Platinum (HMO C-SNP)H5471-1221YesNoNo
Simply Level Platinum (HMO C-SNP)H5471-1261YesNoNo
Simply More (HMO)H5471-0651YesNoNo
Simply More (HMO)H5471-0711YesNoNo
Simply More (HMO)H5471-0741YesNoNo
Simply More (HMO)H5471-0771YesNoNo
Simply More (HMO)H5471-0781YesNoNo
Simply More (HMO)H5471-1101YesNoNo
Simply More Platinum (HMO)H5471-1141YesNoNo
Simply More Platinum (HMO)H5471-1241YesNoNo
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.

Engerix-B at other payers

Or see Engerix-B 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.