Does Bluecross Blueshield Of Tennessee, INC. require prior authorization for Nicotrol?
Bluecross Blueshield Of Tennessee, INC. does not require prior authorization for Nicotrol 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 |
|---|---|---|---|---|---|
| nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol]1797888 | 17 / 17 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| BlueAdvantage Diamond (PPO) | H7917-009 | 4 | No | No | No |
| BlueAdvantage Diamond (PPO) | H7917-010 | 4 | No | No | No |
| BlueAdvantage Diamond (PPO) | H7917-011 | 4 | No | No | No |
| BlueAdvantage Extra (PPO) | H7917-041 | 4 | No | No | No |
| BlueAdvantage Garnet (PPO) | H7917-032 | 4 | No | No | No |
| BlueAdvantage Garnet (PPO) | H7917-033 | 4 | No | No | No |
| BlueAdvantage Ruby (PPO) | H7917-012 | 4 | No | No | No |
| BlueAdvantage Ruby (PPO) | H7917-013 | 4 | No | No | No |
| BlueAdvantage Ruby (PPO) | H7917-014 | 4 | No | No | No |
| BlueAdvantage Ruby (PPO) | H7917-015 | 4 | No | No | No |
| BlueAdvantage Sapphire (PPO) | H7917-030 | 4 | No | No | No |
| BlueAdvantage Sapphire (PPO) | H7917-031 | 4 | No | No | No |
| BlueAdvantage Sapphire (PPO) | H7917-038 | 4 | No | No | No |
| BlueAdvantage Sapphire (PPO) | H7917-040 | 4 | No | No | No |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | H7917-044 | 4 | No | No | No |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | H7917-045 | 4 | No | No | No |
| BlueAdvantage Total Heart and Diabetes Plus (PPO C-SNP) | H7917-046 | 4 | No | No | No |
- 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.
Nicotrol 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.