Benefily
Prior authorization required

Does Ultimate Health Plans, INC. require prior authorization for Engerix-B?

Ultimate Health 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]165815716 / 161600Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B]79842816 / 161600Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B]79843016 / 161600Prior 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
Advantage Care by Ultimate (HMO C-SNP)H2962-0211YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0261YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0291YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0331YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0501YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0511YesNoNo
Advantage Care by Ultimate (HMO C-SNP)H2962-0521YesNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0231YesNoNo
Advantage Care COPD by Ultimate (HMO C-SNP)H2962-0251YesNoNo
Advantage Plus by Ultimate (Full) (HMO D-SNP)H2962-0351YesNoNo
Advantage Plus by Ultimate (Partial) (HMO D-SNP)H2962-0361YesNoNo
Premier by Ultimate (HMO)H2962-0011YesNoNo
Premier by Ultimate (HMO)H2962-0281YesNoNo
Premier by Ultimate (HMO)H2962-0451YesNoNo
Premier by Ultimate (HMO)H2962-0461YesNoNo
Premier by Ultimate (HMO)H2962-0471YesNoNo
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.