Prehevbrio

Generic: hepatitis B surface antigen (isoform L), recombinant

0.01 MG — Vial

Inactivated Hepatitis B Virus Vaccine

Also known as: hepatitis B surface antigen (isoform L), recombinant Prehevbrio 10 Mcg/Ml Vial

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Complete Gold Tier 0 - $0 Preventive QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 0 - $0 Preventive QL
Everyday Bronze Tier 0 - $0 Preventive QL
Elite Bronze Tier 0 - $0 Preventive QL
Clear Silver with $0 Insulin Options Tier 0 - $0 Preventive QL
Standard Expanded Bronze Tier 0 - $0 Preventive QL
Standard Silver Tier 0 - $0 Preventive QL
Standard Gold Tier 0 - $0 Preventive QL
Everyday Bronze with Atrium Health Tier 0 - $0 Preventive QL
Elite Bronze with Atrium Health Tier 0 - $0 Preventive QL
Focused Silver with Atrium Health Tier 0 - $0 Preventive QL
Complete Gold with Atrium Health Tier 0 - $0 Preventive QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Expanded Bronze with Atrium Health Tier 0 - $0 Preventive QL
Standard Silver with Atrium Health Tier 0 - $0 Preventive QL
Standard Gold with Atrium Health Tier 0 - $0 Preventive QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 0 - $0 Preventive QL
Complete Gold + Vision + Adult Dental Tier 0 - $0 Preventive QL
Everyday Bronze + Vision + Adult Dental Tier 0 - $0 Preventive QL
Elite Bronze + Vision + Adult Dental Tier 0 - $0 Preventive QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Expanded Bronze + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Silver + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Gold + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 2 - Preferred Brand None
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