Does Simply Healthcare Plans, INC. require prior authorization for Quadracel?
Simply Healthcare Plans, INC. does not require prior authorization for Quadracel 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 |
|---|---|---|---|---|---|
| 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel]2587057 | 50 / 50 | 0 | 0 | 0 | No prior authorization |
| 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Prefilled Syringe [Quadracel]2593121 | 50 / 50 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel]
Quadracel has 2 products in the corpus; this table is for 0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine, inactivated 0.04 MG/ML / Bordetella pertussis fimbriae 2/3 vaccine, inactivated 0.01 MG/ML / Bordetella pertussis pertactin vaccine, inactivated 0.006 MG/ML / Bordetella pertussis toxoid vaccine, inactivated 0.04 MG/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 10 UNT/ML Injection [Quadracel], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Simply Complete (HMO D-SNP) | H5471-064 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-066 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-072 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-076 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-082 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-084 | 1 | No | No | No |
| Simply Complete (HMO D-SNP) | H5471-111 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-115 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-118 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-121 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-125 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-138 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-140 | 1 | No | No | No |
| Simply Complete Platinum (HMO D-SNP) | H5471-142 | 1 | No | No | No |
| Simply Extra (HMO) | H5471-112 | 1 | No | No | No |
| Simply Extra Platinum (HMO) | H5471-113 | 1 | No | No | No |
| Simply Extra Platinum (HMO) | H5471-117 | 1 | No | No | No |
| Simply Extra Platinum (HMO) | H5471-120 | 1 | No | No | No |
| Simply Extra Platinum (HMO) | H5471-123 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-127 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-128 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-129 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-130 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-131 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-132 | 1 | No | No | No |
| Simply Integrated (HMO D-SNP) | H5471-133 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-134 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-135 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-136 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-137 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-139 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-141 | 1 | No | No | No |
| Simply Integrated Platinum (HMO D-SNP) | H5471-143 | 1 | No | No | No |
| Simply Level (HMO C-SNP) | H5471-069 | 1 | No | No | No |
| Simply Level (HMO C-SNP) | H5471-070 | 1 | No | No | No |
| Simply Level (HMO C-SNP) | H5471-073 | 1 | No | No | No |
| Simply Level (HMO C-SNP) | H5471-075 | 1 | No | No | No |
| Simply Level (HMO C-SNP) | H5471-080 | 1 | No | No | No |
| Simply Level Platinum (HMO C-SNP) | H5471-116 | 1 | No | No | No |
| Simply Level Platinum (HMO C-SNP) | H5471-119 | 1 | No | No | No |
| Simply Level Platinum (HMO C-SNP) | H5471-122 | 1 | No | No | No |
| Simply Level Platinum (HMO C-SNP) | H5471-126 | 1 | No | No | No |
| Simply More (HMO) | H5471-065 | 1 | No | No | No |
| Simply More (HMO) | H5471-071 | 1 | No | No | No |
| Simply More (HMO) | H5471-074 | 1 | No | No | No |
| Simply More (HMO) | H5471-077 | 1 | No | No | No |
| Simply More (HMO) | H5471-078 | 1 | No | No | No |
| Simply More (HMO) | H5471-110 | 1 | No | No | No |
| Simply More Platinum (HMO) | H5471-114 | 1 | No | No | No |
| Simply More Platinum (HMO) | H5471-124 | 1 | No | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Quadracel 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.