Does Alliance Health And Life Insurance Company require prior authorization for Diacomit?
Alliance Health And Life Insurance Company requires prior authorization for Diacomit on every Medicare Part D plan of theirs that covers it.
Every plan from this payer that covers the drug requires authorization before it is dispensed.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| stiripentol 250 MG Oral Capsule [Diacomit]2054979 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| stiripentol 500 MG Oral Capsule [Diacomit]2054983 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| stiripentol 500 MG Powder for Oral Suspension [Diacomit]2055014 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| stiripentol 250 MG Powder for Oral Suspension [Diacomit]2055016 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — stiripentol 250 MG Oral Capsule [Diacomit]
Diacomit has 4 products in the corpus; this table is for stiripentol 250 MG Oral Capsule [Diacomit], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| HAP Medicare Complete Assist (PPO D-SNP) | H2322-020 | 5 | Yes | No | No |
| HAP Medicare Explore (PPO) | H2322-011 | 5 | Yes | No | No |
| HAP Medicare Prime (PPO) | H2322-016 | 5 | Yes | No | No |
| HAP Member Assist (PPO) | H2322-017 | 5 | Yes | No | No |
| HAP Senior Plus (PPO) | H2322-008 | 5 | Yes | No | No |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Diacomit at other payers
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.