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Does Medicare Part D cover Dificid?

Dificid appears on the Medicare Part D formularies of 249 payers in the corpus, across 4,896 plans. 60 payers require prior authorization on every covering plan, 3 on some plans, and 186 on none.

Beyond prior authorization: 118 covering plans require step therapy (another drug tried first) and 1,191 apply a quantity limit, on at least one Dificid product.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

PayerPlans coveringRequire prior authStep therapyQuantity limitStatus
Humana817000No prior authorization
UnitedHealthcare731000No prior authorization
Aetna (CVS Health)658505Varies by plan
Devoted Health415000No prior authorization
Blue Cross Blue Shield (affiliate)183513116Varies by plan
Cigna17100171No prior authorization
Kaiser Permanente115000No prior authorization
SCAN Health Plan740074No prior authorization
Elevance Health (Anthem)676500Varies by plan
Alignment Healthcare670067No prior authorization
Medco Containment Life And Medco Containment Ny600060No prior authorization
Molina Healthcare51000No prior authorization
Simply Healthcare Plans, INC.505000Prior authorization required
Cariten Health Plan INC.44000No prior authorization
Uhc Of California40000No prior authorization
Priority Health3703737No prior authorization
Careplus Health Plans, INC.36000No prior authorization
Bravo Health Pennsylvania, INC.350035No prior authorization
Preferred Care Partners, INC.35000No prior authorization
Zing Health Of Michigan, INC.33000No prior authorization
Health Care Service Corporation310031No prior authorization
Solis Health Plans, INC.240024No prior authorization
Freedom Health, INC.242400Prior authorization required
Capital Advantage Insurance Company230023No prior authorization
Triple S Advantage, INC.220022No prior authorization
Physicians Health Choice Of Texas, LLC22000No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mmm Healthcare, LLC200200No prior authorization
Hcsc Insurance Services Company180018No prior authorization
California Physicians' Service1717017Prior authorization required
Medica Health Plans170017No prior authorization
Bluecross Blueshield Of Tennessee, INC.17000No prior authorization
Wellpoint Texas, INC.161600Prior authorization required
Ultimate Health Plans, INC.16000No prior authorization
Excellus Health Plan, INC.16000No prior authorization
Medical Mutual Of Ohio160016No prior authorization
Optimum Healthcare, INC.151500Prior authorization required
Central Health Plan Of California, INC.15000No prior authorization
Blue Care Network Of Michigan150015No prior authorization
Selecthealth, INC.1401414No prior authorization
Wellpoint Insurance Company141400Prior authorization required
Florida Blue Medicare, INC.130013No prior authorization
Peoples Health, INC.13000No prior authorization
Clover Health13000No prior authorization
Healthsun Health Plans, INC.131300Prior authorization required
Prominence Healthfirst Of Texas130013No prior authorization
Upmc Health Plan, INC.1201212No prior authorization
HMO Louisiana, INC.120012No prior authorization
Mount Carmel Health Plan, INC.11000No prior authorization
Pacificsource Community Health Plans110110No prior authorization
Community Insurance Company101000Prior authorization required
Health Insurance Plan Of Greater New York100010No prior authorization
HMO Colorado, INC.101000Prior authorization required
Compcare Health Services Insurance Corporation101000Prior authorization required
Sanford Health Plan9000No prior authorization
Allina Health And Aetna Insurance Company9000No prior authorization
Geisinger Health Plan9909Prior authorization required
Doctors Healthcare Plans, INC.9909Prior authorization required
Wellpoint Tennessee, INC.9900Prior authorization required
Healthier New Jersey Insurance Company8008No prior authorization
Healthpartners, INC.8800Prior authorization required
Mvp Health Plan, INC.8000No prior authorization
Keystone Health Plan East, INC.8008No prior authorization
Network Health Insurance Corporation8008No prior authorization
Upmc Health Network, INC.8088No prior authorization
Prominence Healthfirst8008No prior authorization
Fallon Community Health Plan8008No prior authorization
Peak Health Insurance Corporation8808Prior authorization required
Health Partners Plans, INC.8008No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care8008No prior authorization
Viva Health, INC.7000No prior authorization
Martin'S Point Generations Advantage, INC.7000No prior authorization
Wellpoint Health Plans, INC.7700Prior authorization required
Bravo Health Mid-Atlantic, INC.7007No prior authorization
Medica Insurance Company7007No prior authorization
Summacare INC.7007No prior authorization
Keystone Health Plan Central, INC.7007No prior authorization
Essence Healthcare PPO, INC.7007No prior authorization
Bluecross And Blueshield Of South Carolina7000No prior authorization
Providence Health Assurance7007No prior authorization
Mass General Brigham Health Plan, INC6000No prior authorization
Christus Health Plan6000No prior authorization
Gold Kidney Of Florida INC6006No prior authorization
Essence Healthcare, INC.6006No prior authorization
Hometown Health Plan, INC.6000No prior authorization
Presbyterian Health Plan6006No prior authorization
Elderplan, INC.6000No prior authorization
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Connecticare, INC.6000No prior authorization
Preferred Care Network, INC.6000No prior authorization
Scott And White Health Plan6006No prior authorization
Hopkins Health Advantage, INC.5000No prior authorization
Sapphire Edge, INC.5005No prior authorization
Independent Health Association, INC.5000No prior authorization
Usable Mutual Insurance Company5000No prior authorization
Gold Kidney Of Arizona5005No prior authorization
Prominence Healthfirst Of Florida INC5005No prior authorization
Priority Health Choice, INC.5055No prior authorization
Hpmp Of Florida, INC.5000No prior authorization
Baylor Scott & White Insurance Company4004No prior authorization
Care N' Care Insurance Company Of North Carolina4000No prior authorization
Health New England, INC.4004No prior authorization
The Health Plan Of West Virginia, INC.4004No prior authorization
Communitycare Government Programs, INC.4404Prior authorization required
Hawaii Medical Service Association4000No prior authorization
Qcc Insurance Company4004No prior authorization
Leon Health, INC.4004No prior authorization
Security Health Plan Of Wisconsin, INC.4000No prior authorization
Sharp Health Plan4000No prior authorization
Gateway Health Plan, INC.4044No prior authorization
Capital Health Plan4004No prior authorization
Boston Medical Center Health Plan, INC.4004No prior authorization
Bluecross Blueshield Kansas Solutions, INC.4004No prior authorization
Clever Care Of Golden State, INC.4000No prior authorization
Central Mass Health, LLC4004No prior authorization
Ghs Insurance Company4004No prior authorization
Thp Insurance Company4004No prior authorization
Amh Health, LLC4400Prior authorization required
Dean Health Plan, INC.4404Prior authorization required
Medisun, INC.3000No prior authorization
Metroplus Health Plan, INC.3000No prior authorization
Wellpoint West Virginia , INC.3300Prior authorization required
Louisiana Health Service & Indemnity Company3003No prior authorization
Eternalhealth, INC.3000No prior authorization
Patrius Health, INC.3003No prior authorization
Marquis Advantage, INC.3303Prior authorization required
Partners Insurance Company INC3003No prior authorization
Mount Carmel Health Insurance Company3000No prior authorization
Community Care Health Plan Of Louisiana, INC.3300Prior authorization required
Senior Whole Health, LLC3000No prior authorization
Secur INC3303Prior authorization required
Wellpoint New Jersey, INC.3300Prior authorization required
Volunteer State Health Plan3000No prior authorization
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3000No prior authorization
Procare Advantage, LLC3303Prior authorization required
Eternalhealth Of Arizona INC3000No prior authorization
Paramount Care, INC.3000No prior authorization
Aultcare Health Insuring Corporation3030No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3000No prior authorization
Geisinger Indemnity Insurance Company3303Prior authorization required
Simpra Advantage, INC.3303Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3000No prior authorization
Provider Partners Health Plan Of North Carolina3000No prior authorization
Provider Partners Health Plan Of Indiana3000No prior authorization
Amerihealth Insurance Company Of New Jersey3003No prior authorization
Mercy Care3000No prior authorization
Usable HMO, INC.3000No prior authorization
Liberty Advantage, LLC3303Prior authorization required
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3000No prior authorization
Hamaspik, INC.2002No prior authorization
Arizona Physicians Ipa, INC.2000No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Amerihealth Caritas Vip Next, INC.2002No prior authorization
Beshp, INC.2000No prior authorization
Wellpoint Iowa, INC.2200Prior authorization required
Commonwealth Care Alliance, INC.2000No prior authorization
Wellpoint Washington, INC.2200Prior authorization required
Neighborhood Health Plan Of Rhode Island2000No prior authorization
Village Senior Services Corporation2002No prior authorization
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2202Prior authorization required
South Country Health Alliance2000No prior authorization
Sentara Health Plans2202Prior authorization required
Partners Insurance Company Of New Jersey INC2002No prior authorization
Sanford Health Plan Of Minnesota2000No prior authorization
Nhc Advantage, LLC2202Prior authorization required
Vista Health Plan, INC.2002No prior authorization
American Health Plan Of Ut, INC.2202Prior authorization required
American Health Plan Of Missouri, INC.2202Prior authorization required
Troy Health, INC.2000No prior authorization
Banner - University Care Advantage2002No prior authorization
Tufts Health Public Plans, INC.2000No prior authorization
Vns Choice2002No prior authorization
Community Health Plan Of Washington2002No prior authorization
Senior Whole Health Of New York, INC.2000No prior authorization
Nextblue Of North Dakota Insurance Company2002No prior authorization
Healthpartners Insurance Company2200Prior authorization required
Missouri Care, Incorporated2200Prior authorization required
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
American Health Plan Of Iowa INC2202Prior authorization required
Elderserve Health, INC.2002No prior authorization
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2202Prior authorization required
Memorial Hermann Health Plan2002No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2000No prior authorization
Excellus Health Plan Community Care LLC2000No prior authorization
Group Health Cooperative Of Eau Claire2002No prior authorization
Georgia Assurance, INC.2202Prior authorization required
Caresource Georgia CO.2002No prior authorization
Trinity Health Plan Of Michigan INC2000No prior authorization
Wyoblue Advantage INC2002No prior authorization
Community Health Choice Texas, INC.2202Prior authorization required
Mount Carmel Health Plan Of New York, INC.2000No prior authorization
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2002No prior authorization
Hm Health Insurance Company2002No prior authorization
Horizon Insurance Company2002No prior authorization
Longevity Health Plan Of Colorado, INC.1001No prior authorization
Local Initiative Health Authority For La County1101Prior authorization required
Johns Hopkins Health Plan Of Virginia, INC.1000No prior authorization
Longevity Health Plan Of Florida, INC.1001No prior authorization
Alameda Alliance For Health1000No prior authorization
Independent Care Health Plan1000No prior authorization
Itasca Medical Care1000No prior authorization
HMO Minnesota1001No prior authorization
Amerihealth Caritas Louisiana, INC.1001No prior authorization
Wellpoint South Carolina, INC.1100Prior authorization required
Upper Peninsula Health Plan, LLC1001No prior authorization
Connecticare Insurance Company, INC.1000No prior authorization
Independent Health Benefits Corporation1000No prior authorization
Oklahoma Superior Select, INC.1101Prior authorization required
Provider Partners Health Plan Of Illinois1000No prior authorization
Samaritan Health Plans, INC.1000No prior authorization
Ghs Health Maintenance Organization, INC.1001No prior authorization
Provider Partners Health Plan Of Texas, INC.1000No prior authorization
Hap Caresource1001No prior authorization
Select Health Of South Carolina, INC.1001No prior authorization
Contra Costa County Medical Service Dba Contra Costa Health1000No prior authorization
Paramount Insurance Company1000No prior authorization
Longevity Health Plan Of North Carolina, INC.1001No prior authorization
Orange County Health Authority1001No prior authorization
Health Choice Arizona, INC.1000No prior authorization
Banner Health Plan, INC.1001No prior authorization
Aids Healthcare Foundation1001No prior authorization
Health Plan Of Careoregon, INC.1101Prior authorization required
Alohacare1000No prior authorization
Amerihealth Michigan, INC.1001No prior authorization
Amerihealth Caritas Florida, INC.1001No prior authorization
Caresource Ohio, INC.1001No prior authorization
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1101Prior authorization required
Provider Partners Health Plan Of Kentucky1000No prior authorization
Longevity Health Plan Of Michigan, INC.1001No prior authorization
American Health Plan, INC.1101Prior authorization required
Amerihealth Caritas North Carolina, INC.1001No prior authorization
Horizon Healthcare Of New Jersey, INC.1001No prior authorization
Longevity Health Plan Of New York, INC.1001No prior authorization
Hawaii Medical Service Association (Hmsa)1000No prior authorization
Dignity Care Corporation1101Prior authorization required
Healthy Mississippi, INC.1011No prior authorization
Longevity Health Plan Of Illinois, INC.1001No prior authorization
Ventura County Medi-Cal Managed Care Commission1001No prior authorization
Healthfirst Insurance Company, INC.1000No prior authorization
American Health Plan Of Indiana INC1101Prior authorization required
American Health Plan Of Ms, INC.1101Prior authorization required
American Health Plan Of Pennsylvania INC1101Prior authorization required

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Dificid product on its formulary carries that condition.

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.

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.