No prior authorization
Does Blue Cross Blue Shield (affiliate) require prior authorization for Matzim?
Blue Cross Blue Shield (affiliate) does not require prior authorization for Matzim on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim]1091623 | 89 / 269 | 0 | 0 | 0 | No prior authorization |
| 24 HR diltiazem hydrochloride 240 MG Extended Release Oral Tablet [Matzim]1091629 | 89 / 269 | 0 | 0 | 0 | No prior authorization |
| 24 HR diltiazem hydrochloride 180 MG Extended Release Oral Tablet [Matzim]1091632 | 89 / 269 | 0 | 0 | 0 | No prior authorization |
| 24 HR diltiazem hydrochloride 300 MG Extended Release Oral Tablet [Matzim]1091635 | 89 / 269 | 0 | 0 | 0 | No prior authorization |
| 24 HR diltiazem hydrochloride 360 MG Extended Release Oral Tablet [Matzim]1091638 | 89 / 269 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim]
Matzim has 5 products in the corpus; this table is for 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Anthem Dual Advantage (HMO D-SNP) | H5422-018 | 4 | No | No | No |
| Anthem Extra Help (HMO-POS) | H5422-013 | 4 | No | No | No |
| Anthem Full Dual Advantage (HMO D-SNP) | H5422-019 | 4 | No | No | No |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-010 | 4 | No | No | No |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-010 | 4 | No | No | No |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | H4471-011 | 4 | No | No | No |
| Anthem Kidney Care (HMO-POS C-SNP) | H5422-015 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-056 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-061 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-062 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-063 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-064 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-065 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-095 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-096 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H0544-108 | 4 | No | No | No |
| Anthem Medicare Advantage (HMO-POS) | H5422-011 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-002 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-003 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-004 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-005 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-006 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-007 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-009 | 4 | No | No | No |
| Anthem Prime (HMO-POS) | H4161-010 | 4 | No | No | No |
| Anthem Select (HMO-POS) | H0544-058 | 4 | No | No | No |
| Anthem Select (HMO-POS) | H0544-066 | 4 | No | No | No |
| Anthem Select (HMO-POS) | H0544-069 | 4 | No | No | No |
| Anthem Select (HMO-POS) | H0544-091 | 4 | No | No | No |
| Anthem Select (HMO-POS) | H0544-098 | 4 | No | No | No |
| Blue Advantage Complete (PPO) | H0104-012 | 2 | No | No | No |
| Blue Advantage Complete (PPO) | H0104-014 | 2 | No | No | No |
| Blue Advantage Premier (PPO) | H0104-015 | 2 | No | No | No |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-009 | 2 | No | No | No |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-014 | 2 | No | No | No |
| Blue Cross Medicare Advantage Choice (PPO) | H5959-014 | 2 | No | No | No |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-010 | 2 | No | No | No |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-010 | 2 | No | No | No |
| Blue Cross Medicare Advantage Complete (PPO) | H5959-011 | 2 | No | No | No |
| Blue Cross Medicare Advantage Secure (HMO) | H8547-001 | 2 | No | No | No |
| Blue Medicare Choice (HMO) | H3449-026 | 2 | No | No | No |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 2 | No | No | No |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 2 | No | No | No |
| Blue Medicare Enhanced (HMO-POS) | H3449-024 | 2 | No | No | No |
| Blue Medicare Essential (HMO) | H3449-027 | 2 | No | No | No |
| Blue Medicare Essential (HMO) | H3449-027 | 2 | No | No | No |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 2 | No | No | No |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 2 | No | No | No |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 2 | No | No | No |
| Blue Medicare Essential Plus (HMO-POS) | H3449-023 | 2 | No | No | No |
| Blue Medicare PPO Enhanced (PPO) | H3404-003 | 2 | No | No | No |
| Blue Medicare PPO Enhanced (PPO) | H3404-003 | 2 | No | No | No |
| Blue Medicare Rx Enhanced (PDP) | S5540-004 | 3 | No | No | No |
| Blue MedicareRx Plus (PDP) | S5726-014 | 3 | No | No | No |
| Experience Health Medicare Advantage (HMO) | H3777-002 | 2 | No | No | No |
| Freedom Blue PPO Classic (PPO) | H3916-001 | 2 | No | No | No |
| Freedom Blue PPO Classic (PPO) | H3916-002 | 2 | No | No | No |
| Freedom Blue PPO Deluxe (PPO) | H3916-005 | 2 | No | No | No |
| Freedom Blue PPO Select (PPO) | H3916-022 | 2 | No | No | No |
| Freedom Blue PPO Select (PPO) | H3916-024 | 2 | No | No | No |
| Freedom Blue PPO Standard (PPO) | H3916-015 | 2 | No | No | No |
| Healthy Blue + Medicare (HMO-POS D-SNP) | H9147-001 | 2 | No | No | No |
| Platinum Blue Choice Plan with Rx (Cost) | H2461-009 | 2 | No | No | No |
| Platinum Blue Complete Plan with Rx (Cost) | H2461-010 | 2 | No | No | No |
| Regence BlueAdvantage HMO (HMO) | H1997-013 | 3 | No | No | No |
| Regence BlueAdvantage HMO (HMO) | H6237-009 | 3 | No | No | No |
| Regence MedAdvantage + Rx Classic (PPO) | H3817-008 | 3 | No | No | No |
| Regence MedAdvantage + Rx Classic (PPO) | H3817-008 | 3 | No | No | No |
| Regence MedAdvantage + Rx Classic (PPO) | H3817-008 | 3 | No | No | No |
| Regence MedAdvantage + Rx Classic (PPO) | H4605-002 | 3 | No | No | No |
| Regence MedAdvantage + Rx Enhanced (PPO) | H3817-009 | 3 | No | No | No |
| Regence MedAdvantage + Rx Enhanced (PPO) | H3817-009 | 3 | No | No | No |
| Regence MedAdvantage + Rx Enhanced (PPO) | H4605-004 | 3 | No | No | No |
| Regence MedAdvantage + Rx Enhanced (PPO) | H5009-002 | 3 | No | No | No |
| Regence MedAdvantage + Rx Primary (PPO) | H3817-011 | 3 | No | No | No |
| Regence MedAdvantage + Rx Primary (PPO) | H3817-011 | 3 | No | No | No |
| Regence MedAdvantage + Rx Primary (PPO) | H3817-011 | 3 | No | No | No |
| Regence MedAdvantage + Rx Primary (PPO) | H5009-011 | 3 | No | No | No |
| Regence MedAdvantage + Rx Primary (PPO) | H5009-011 | 3 | No | No | No |
| Security Blue HMO-POS Deluxe (HMO-POS) | H3957-046 | 2 | No | No | No |
| Security Blue HMO-POS Deluxe (HMO-POS) | H3957-046 | 2 | No | No | No |
| Security Blue HMO-POS Standard (HMO-POS) | H3957-045 | 2 | No | No | No |
| Security Blue HMO-POS Standard (HMO-POS) | H3957-045 | 2 | No | No | No |
| True Blue Rx 32PSP (HMO) | H1350-032 | 4 | No | No | No |
| True Blue Rx 33 (HMO) | H1350-033 | 4 | No | No | No |
| True Blue Rx 34 (HMO) | H1350-034 | 4 | No | No | No |
| True Blue Rx 35PSP (HMO) | H1350-035 | 4 | No | No | No |
| True Blue Rx 36 (HMO) | H1350-036 | 4 | No | No | No |
| True Blue Rx 37 (HMO) | H1350-037 | 4 | No | 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.
Matzim 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.