Medicare Part D coverage · 0.5 · RxCUI 2050059
0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B]
Per the CMS 2026 Part D formulary file, 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.2, with prior authorization required on 100% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.2
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B]
Per the CMS 2026 Part D formulary file, 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] (RxNorm concept RXCUI 2050059, generic name 0.5) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.2.
Real-world access to 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 1.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,197 Part D beneficiaries filled 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] in 2023, with total plan-and-beneficiary spending of $799,753 and an average per-beneficiary annual cost of $250.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,197
- Total spending
- $799,753
- Avg per beneficiary
- $250.16
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
Show the next 30 plans
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T1 | Yes | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | Yes | $0 | IL |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IA |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | NE |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Advantra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | SD |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | KS |
| Aetna Medicare Dual Extra (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | Yes | $0 | AR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] covered by Medicare Part D?
Yes, 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] on Medicare Part D plans?
0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] require prior authorization?
100% of Part D formularies require prior authorization for 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B]. Step therapy: 0%. Quantity limits: 1.8%.
How much does Medicare spend on 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B]?
In 2023, total Medicare Part D spending on 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] was $799,753, covering 3,197 beneficiaries. The average spend per beneficiary was $250.16.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA