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Does Medicare Part D cover Valtoco 15 MG Dose Kit?

Valtoco 15 MG Dose Kit appears on the Medicare Part D formularies of 317 payers in the corpus, across 5,496 plans. 100 payers require prior authorization on every covering plan, 3 on some plans, and 214 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 5,187 apply a quantity limit, on at least one Valtoco 15 MG Dose Kit 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
Humana81700817No prior authorization
UnitedHealthcare7317310731Prior authorization required
Aetna (CVS Health)6586360648Varies by plan
Devoted Health41500415No prior authorization
Blue Cross Blue Shield (affiliate)2691280266Varies by plan
Centene (WellCare)1971970197Prior authorization required
Cigna1711710171Prior authorization required
Kaiser Permanente115000No prior authorization
SCAN Health Plan747400Prior authorization required
Elevance Health (Anthem)670067No prior authorization
Alignment Healthcare670067No prior authorization
Medco Containment Life And Medco Containment Ny6060060Prior authorization required
Molina Healthcare510051No prior authorization
Simply Healthcare Plans, INC.500050No prior authorization
Cariten Health Plan INC.440044No prior authorization
Uhc Of California4040040Prior authorization required
Priority Health3737037Prior authorization required
Careplus Health Plans, INC.360036No prior authorization
Bravo Health Pennsylvania, INC.3535035Prior authorization required
Preferred Care Partners, INC.3535035Prior authorization required
Zing Health Of Michigan, INC.330033No prior authorization
Health Care Service Corporation310031No prior authorization
Solis Health Plans, INC.240024No prior authorization
Sunshine State Health Plan, INC.2424024Prior authorization required
Freedom Health, INC.240024No prior authorization
Capital Advantage Insurance Company230023No prior authorization
Triple S Advantage, INC.22000No prior authorization
Physicians Health Choice Of Texas, LLC2222022Prior authorization required
Tufts Associated Health Maintenance Organization2121021Prior authorization required
Mmm Healthcare, LLC202000Prior authorization required
Mcs Advantage, INC.2020020Prior authorization required
Harmony Health Plan, INC.1919019Prior authorization required
Hcsc Insurance Services Company180018No prior authorization
California Physicians' Service170017No prior authorization
Medica Health Plans1717017Prior authorization required
Upmc Health Plan, INC.170017No prior authorization
Bluecross Blueshield Of Tennessee, INC.170017No prior authorization
Wellpoint Texas, INC.160016No prior authorization
Ultimate Health Plans, INC.160016No prior authorization
Excellus Health Plan, INC.16000No prior authorization
Medical Mutual Of Ohio1616016Prior authorization required
Superior Healthplan, INC.1515015Prior authorization required
Florida Blue Medicare, INC.152015Varies by plan
Optimum Healthcare, INC.150015No prior authorization
Central Health Plan Of California, INC.150015No prior authorization
Blue Care Network Of Michigan1515015Prior authorization required
Selecthealth, INC.140014No prior authorization
Wellpoint Insurance Company140014No prior authorization
Peoples Health, INC.1313013Prior authorization required
Clover Health130013No prior authorization
Healthsun Health Plans, INC.130013No prior authorization
Prominence Healthfirst Of Texas13000No prior authorization
Atrio Health Plans120012No prior authorization
Upmc Health Network, INC.120012No prior authorization
HMO Louisiana, INC.1212012Prior authorization required
Mount Carmel Health Plan, INC.110011No prior authorization
Pacificsource Community Health Plans110011No prior authorization
Community Insurance Company100010No prior authorization
Health Insurance Plan Of Greater New York100010No prior authorization
HMO Colorado, INC.100010No prior authorization
Quartz Health Plan Corporation100010No prior authorization
Compcare Health Services Insurance Corporation100010No prior authorization
Sanford Health Plan9009No prior authorization
Allina Health And Aetna Insurance Company9909Prior authorization required
Geisinger Health Plan9009No prior authorization
Doctors Healthcare Plans, INC.9009No prior authorization
New York Quality Healthcare Corporation9909Prior authorization required
Wellpoint Tennessee, INC.9009No prior authorization
Healthier New Jersey Insurance Company8008No prior authorization
Meridian Health Plan Of Michigan, INC.8808Prior authorization required
Healthpartners, INC.8808Prior authorization required
American Progressive Life & Hlth Ins Company Of Ny8808Prior authorization required
Mvp Health Plan, INC.8008No prior authorization
Keystone Health Plan East, INC.8808Prior authorization required
Network Health Insurance Corporation8008No prior authorization
Prominence Healthfirst8000No prior authorization
Fallon Community Health Plan8008No prior authorization
Peak Health Insurance Corporation8008No prior authorization
Health Partners Plans, INC.8808Prior authorization required
Medco Containment Life & Medco Containment Ny & Health Care8008No prior authorization
Viva Health, INC.7007No prior authorization
Martin'S Point Generations Advantage, INC.7007No prior authorization
Wellpoint Health Plans, INC.7007No prior authorization
Astiva Health, INC.7007No prior authorization
Bravo Health Mid-Atlantic, INC.7707Prior authorization required
Health Alliance Plan Of Michigan7707Prior authorization required
Medica Insurance Company7707Prior authorization required
Summacare INC.7007No prior authorization
Keystone Health Plan Central, INC.7007No prior authorization
Champion Health Plan Of California INC7007No prior authorization
Essence Healthcare PPO, INC.7707Prior authorization required
Champion Health Plan Of Nevada, INC.7007No prior authorization
Bluecross And Blueshield Of South Carolina7007No prior authorization
Providence Health Assurance7007No prior authorization
Alterwood Advantage, INC.7007No prior authorization
Mass General Brigham Health Plan, INC6606Prior authorization required
Buckeye Community Health Plan, INC.6606Prior authorization required
Christus Health Plan6006No prior authorization
Nebraska Total Care, INC.6606Prior authorization required
Gold Kidney Of Florida INC6006No prior authorization
Essence Healthcare, INC.6606Prior authorization required
Hometown Health Plan, INC.6006No prior authorization
Presbyterian Health Plan6006No prior authorization
Elderplan, INC.6006No prior authorization
Perennial Advantage Of Colorado, INC.6006No prior authorization
Connecticare, INC.6006No prior authorization
Globalhealth, INC.6006No prior authorization
Preferred Care Network, INC.6606Prior authorization required
Scott And White Health Plan6006No prior authorization
Coordinated Care Of Washington, INC.5505Prior authorization required
Chinese Community Health Plan5005No prior authorization
Hopkins Health Advantage, INC.5005No prior authorization
Alliance Health And Life Insurance Company5505Prior authorization required
Sapphire Edge, INC.5005No prior authorization
Independent Health Association, INC.5500Prior authorization required
Coordinated Care Corporation5505Prior authorization required
Oh Chs Snp INC.5005No prior authorization
Usable Mutual Insurance Company5005No prior authorization
Gold Kidney Of Arizona5005No prior authorization
Meridian Health Plan Of Illinois, INC.5505Prior authorization required
Sunflower State Health Plan, INC.5505Prior authorization required
Prominence Healthfirst Of Florida INC5000No prior authorization
Priority Health Choice, INC.5505Prior authorization required
Arkansas Health & Wellness Health Plan, INC.5505Prior authorization required
Hpmp Of Florida, INC.5005No prior authorization
Home State Health Plan, INC.4404Prior authorization required
Baylor Scott & White Insurance Company4004No prior authorization
Care N' Care Insurance Company Of North Carolina4004No prior authorization
Health New England, INC.4004No prior authorization
Pennsylvania Health & Wellness, INC.4404Prior authorization required
The Health Plan Of West Virginia, INC.4404Prior authorization required
Communitycare Government Programs, INC.4004No prior authorization
Hawaii Medical Service Association4004No prior authorization
Qcc Insurance Company4404Prior authorization required
Leon Health, INC.4000No prior authorization
Verda Health Plan Of Texas INC4004No prior authorization
Security Health Plan Of Wisconsin, INC.4004No prior authorization
Sharp Health Plan4004No prior authorization
Gateway Health Plan, INC.4400Prior authorization required
Capital Health Plan4004No prior authorization
Boston Medical Center Health Plan, INC.4404Prior authorization required
Bluecross Blueshield Kansas Solutions, INC.4004No prior authorization
Clever Care Of Golden State, INC.4004No prior authorization
Central Mass Health, LLC4004No prior authorization
Ghs Insurance Company4004No prior authorization
Thp Insurance Company4404Prior authorization required
Aspire Health Plan4004No prior authorization
Amh Health, LLC4004No prior authorization
Dean Health Plan, INC.4004No prior authorization
Quartz Health Plan Mn Corporation4004No prior authorization
Medisun, INC.3003No prior authorization
Metroplus Health Plan, INC.3003No prior authorization
Wellpoint West Virginia , INC.3003No prior authorization
Louisiana Health Service & Indemnity Company3303Prior authorization required
Eternalhealth, INC.3003No prior authorization
Patrius Health, INC.3003No prior authorization
Marquis Advantage, INC.3003No prior authorization
Partners Insurance Company INC3303Prior authorization required
Mount Carmel Health Insurance Company3003No prior authorization
Community Care Health Plan Of Louisiana, INC.3003No prior authorization
Village Senior Services Corporation3003No prior authorization
Trillium Community Health Plan, INC.3303Prior authorization required
Senior Whole Health, LLC3003No prior authorization
Baycare Select Health Plans, INC.3003No prior authorization
Cox Health Systems HMO INC3003No prior authorization
Secur INC3003No prior authorization
Wellpoint New Jersey, INC.3003No prior authorization
Volunteer State Health Plan3003No prior authorization
Align Senior Care California INC.3003No prior authorization
Pruitthealth Premier, INC.3003No prior authorization
Capital District Physicians' Health Plan, INC.3000No prior authorization
Procare Advantage, LLC3003No prior authorization
Eternalhealth Of Arizona INC3003No prior authorization
Paramount Care, INC.3003No prior authorization
Aultcare Health Insuring Corporation3000No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3003No prior authorization
Geisinger Indemnity Insurance Company3003No prior authorization
Simpra Advantage, INC.3003No prior authorization
Provider Partners Health Plan Of Pennsylvania, INC3003No prior authorization
Provider Partners Health Plan Of North Carolina3003No prior authorization
Provider Partners Health Plan Of Indiana3003No prior authorization
Celtic Insurance Company3303Prior authorization required
Amerihealth Insurance Company Of New Jersey3303Prior authorization required
Vns Choice3003No prior authorization
Mercy Care3003No prior authorization
Usable HMO, INC.3003No prior authorization
Mclaren Health Plan, INC.3003No prior authorization
Liberty Advantage, LLC3003No prior authorization
Southeastern Indiana Health Organization, INC.3003No prior authorization
Managed Health Services Insurance CORP.3303Prior authorization required
Perennial Advantage Of Ohio, INC.3003No prior authorization
Provider Partners Health Plan Of Missouri, INC.3003No prior authorization
Hamaspik, INC.2002No prior authorization
Arizona Physicians Ipa, INC.2202Prior authorization required
Ks Plan Administrators, LLC2002No prior authorization
Carepartners Of Connecticut, INC.2202Prior authorization required
Amerihealth Caritas Vip Next, INC.2202Prior authorization required
Beshp, INC.2002No prior authorization
Wellpoint Iowa, INC.2002No prior authorization
Commonwealth Care Alliance, INC.2002No prior authorization
Arkansas Superior Select, INC.2002No prior authorization
Wellpoint Washington, INC.2002No prior authorization
Neighborhood Health Plan Of Rhode Island2002No prior authorization
Lifeworks Advantage, LLC2002No prior authorization
Kansas Superior Select, INC.2002No prior authorization
Signature Advantage, LLC2002No prior authorization
Primewest Rural Mn Health Care Access Initiative2002No prior authorization
South Country Health Alliance2202Prior authorization required
Sentara Health Plans2202Prior authorization required
Verda Health Plan Of Arizona, INC.2002No prior authorization
Partners Insurance Company Of New Jersey INC2202Prior authorization required
Sanford Health Plan Of Minnesota2002No prior authorization
Nhc Advantage, LLC2002No prior authorization
Vista Health Plan, INC.2202Prior authorization required
American Health Plan Of Ut, INC.2002No prior authorization
Upmc For You, INC2002No prior authorization
American Health Plan Of Missouri, INC.2002No prior authorization
Selectcare Of Texas, INC.2202Prior authorization required
New Century Health Plan, INC.2002No prior authorization
Troy Health, INC.2202Prior authorization required
Community Health Group2002No prior authorization
Banner - University Care Advantage2202Prior authorization required
Texas Independence Health Plan, INC.2002No prior authorization
Tufts Health Public Plans, INC.2202Prior authorization required
Imperial Health Plan Of California, INC.2002No prior authorization
Bridgeway Health Solutions Of Arizona, INC.2202Prior authorization required
Denver Health Medical Plan, INC.2002No prior authorization
Community Health Plan Of Washington2202Prior authorization required
Senior Whole Health Of New York, INC.2002No prior authorization
Nextblue Of North Dakota Insurance Company2202Prior authorization required
Healthpartners Insurance Company2202Prior authorization required
Missouri Care, Incorporated2002No prior authorization
Pruitthealth Premier North Carolina, LLC2002No prior authorization
Elite Health Plan, INC.2002No prior authorization
American Health Plan Of Iowa INC2002No prior authorization
Elderserve Health, INC.2202Prior authorization required
Align Senior Care Mi, LLC2002No prior authorization
Isnp Ventures, LLC2002No prior authorization
Memorial Hermann Health Plan2002No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2002No prior authorization
Excellus Health Plan Community Care LLC2000No prior authorization
Group Health Cooperative Of Eau Claire2202Prior authorization required
Georgia Assurance, INC.2002No prior authorization
Caresource Georgia CO.2202Prior authorization required
Visiting Nurse Association Of Central New York2002No prior authorization
Trinity Health Plan Of Michigan INC2002No prior authorization
Wyoblue Advantage INC2202Prior authorization required
Community Health Choice Texas, INC.2002No prior authorization
Mount Carmel Health Plan Of New York, INC.2002No prior authorization
Align Senior Care Florida, INC.2002No prior authorization
Longevity Health Plan Of New Jersey Insurance Comp2202Prior authorization required
Hm Health Insurance Company2202Prior authorization required
Horizon Insurance Company2002No prior authorization
Longevity Health Plan Of Colorado, INC.1101Prior authorization required
Tsg Guard, INC.1001No prior authorization
Local Initiative Health Authority For La County1001No prior authorization
Johns Hopkins Health Plan Of Virginia, INC.1001No prior authorization
Longevity Health Plan Of Florida, INC.1101Prior authorization required
Imperial County Local Health Authority1001No prior authorization
Community Care Health Plan, INC.1000No prior authorization
Alameda Alliance For Health1101Prior authorization required
Independent Care Health Plan1001No prior authorization
Itasca Medical Care1001No prior authorization
HMO Minnesota1001No prior authorization
Amerihealth Caritas Louisiana, INC.1101Prior authorization required
Wellpoint South Carolina, INC.1001No prior authorization
Upper Peninsula Health Plan, LLC1101Prior authorization required
Connecticare Insurance Company, INC.1001No prior authorization
Independent Health Benefits Corporation1100Prior authorization required
Oklahoma Superior Select, INC.1001No prior authorization
Provider Partners Health Plan Of Illinois1001No prior authorization
Allcare Health Plan, INC.1001No prior authorization
Samaritan Health Plans, INC.1001No prior authorization
Ghs Health Maintenance Organization, INC.1001No prior authorization
Santa Clara County Health Authority1001No prior authorization
Provider Partners Health Plan Of Texas, INC.1001No prior authorization
Kern Health Systems1001No prior authorization
Hap Caresource1101Prior authorization required
Select Health Of South Carolina, INC.1101Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health1101Prior authorization required
Paramount Insurance Company1001No prior authorization
Absolute Total Care, INC.1101Prior authorization required
Longevity Health Plan Of North Carolina, INC.1101Prior authorization required
Orange County Health Authority1101Prior authorization required
Health Choice Arizona, INC.1001No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1001No prior authorization
San Joaquin County Health Commission1001No prior authorization
Banner Health Plan, INC.1101Prior authorization required
Aids Healthcare Foundation1001No prior authorization
Health Plan Of Careoregon, INC.1001No prior authorization
Alohacare1001No prior authorization
San Mateo Health Commission1101Prior authorization required
Amerihealth Michigan, INC.1101Prior authorization required
Amerihealth Caritas Florida, INC.1101Prior authorization required
Caresource Ohio, INC.1101Prior authorization required
Lagniappe Advantage Insurance Company1001No prior authorization
American Health Plan Of Fl, INC.1001No prior authorization
Upmc Health Coverage, INC.1001No prior authorization
Provider Partners Health Plan Of Kentucky1001No prior authorization
Longevity Health Plan Of Michigan, INC.1101Prior authorization required
Santa Barbara San Luis Obispo Regional Health Authority Dba1001No prior authorization
American Health Plan, INC.1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1001No prior authorization
Amerihealth Caritas North Carolina, INC.1101Prior authorization required
Horizon Healthcare Of New Jersey, INC.1001No prior authorization
Longevity Health Plan Of New York, INC.1101Prior authorization required
Hawaii Medical Service Association (Hmsa)1001No prior authorization
Dignity Care Corporation1001No prior authorization
Healthy Mississippi, INC.1001No prior authorization
Inland Empire Health Plan1001No prior authorization
West Virginia Senior Advantage, INC.1001No prior authorization
Longevity Health Plan Of Illinois, INC.1101Prior authorization required
Ventura County Medi-Cal Managed Care Commission1001No prior authorization
Healthfirst Insurance Company, INC.1001No prior authorization
American Health Plan Of Indiana INC1001No prior authorization
American Health Plan Of Ms, INC.1001No prior authorization
American Health Plan Of Pennsylvania INC1001No prior authorization

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Valtoco 15 MG Dose Kit 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.