PrefeRxPradaxa Oral capsule
Pradaxa Oral capsule
This medication requires prior authorization from insurance before it can be filled.
Drug Package Insert
Not available
Tier
E
The formulary for this drug has 4 tiers, expand to see them all
1
Lower Cost. Medications that provide the highest overall value. Mostly generic drugs. Some brand-name drugs may also be included.
2
Mid-range Cost. Medications that provide good overall value. Mainly preferred brand-name drugs.
3
Highest Cost. Medications that provide the lowest overall value.
E
Requirements and Limits
Prior Authorization
The plan requires you or your doctor or prescriber to get prior approval for certain drugs. This means the plan needs more information from your doctor or prescriber to make sure the drug is being used and covered correctly by Medicare for your medical condition
Quantity Limits
The plan will only cover a certain amount of this drug for 1 copay or over a certain number of days. These limits can help ensure safe and effective use of the drug.
Insurer
United Healthcare
Plan Name
Access 3-Tier
Category
Anticoagulants - Drugs to Treat or Prevent Blood Clots
Drug Classes
Tags
None
History
Requirements Changed
QLPA, QL
Nov 2025
Tier Changed
2E
Nov 2025
Added to PrefeRx
Sep 2025