Prior authorization required

Does Baylor Scott & White Insurance Company require prior authorization for Matulane?

Baylor Scott & White Insurance Company requires prior authorization for Matulane 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
procarbazine 50 MG Oral Capsule [Matulane]207588	4 / 4	4	0	0	Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — procarbazine 50 MG Oral Capsule [Matulane]

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
BSW SeniorCare Advantage (PPO)	H2032-001	5	Yes	No	No
BSW SeniorCare Advantage (PPO)	H2032-004	5	Yes	No	No
BSW SeniorCare Advantage Basic (PPO)	H2032-002	5	Yes	No	No
BSW SeniorCare Advantage Platinum (PPO)	H2032-003	5	Yes	No	No

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.

Matulane at other payers

Or see Matulane across every payer at once.

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.