No prior authorization
Does Cariten Health Plan INC. require prior authorization for Valtoco 5 MG Dose Kit?
Cariten Health Plan INC. does not require prior authorization for Valtoco 5 MG Dose Kit 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 |
|---|---|---|---|---|---|
| {1 (0.1 ML) (diazepam 50 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]2272630 | 44 / 44 | 0 | 0 | 44 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — {1 (0.1 ML) (diazepam 50 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Humana Community (HMO-POS) | H4461-048 | 5 | No | No | Yes |
| Humana Dual Select H4461-077 (HMO D-SNP) | H4461-077 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H4461-039 (HMO) | H4461-039 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H4461-045 (HMO) | H4461-045 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-042 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-063 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-065 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-066 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-067 | 5 | No | No | Yes |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H4461-068 | 5 | No | No | Yes |
| Humana Gold Plus H4461-025 (HMO) | H4461-025 | 5 | No | No | Yes |
| Humana Gold Plus H4461-035 (HMO) | H4461-035 | 5 | No | No | Yes |
| Humana Gold Plus H4461-040 (HMO) | H4461-040 | 5 | No | No | Yes |
| Humana Gold Plus H4461-041 (HMO) | H4461-041 | 5 | No | No | Yes |
| Humana Gold Plus H4461-050 (HMO) | H4461-050 | 5 | No | No | Yes |
| Humana Gold Plus H4461-052 (HMO) | H4461-052 | 5 | No | No | Yes |
| Humana Gold Plus H4461-053 (HMO) | H4461-053 | 5 | No | No | Yes |
| Humana Gold Plus H4461-054 (HMO) | H4461-054 | 5 | No | No | Yes |
| Humana Gold Plus H4461-055 (HMO) | H4461-055 | 5 | No | No | Yes |
| Humana Gold Plus H4461-056 (HMO) | H4461-056 | 5 | No | No | Yes |
| Humana Gold Plus H4461-057 (HMO) | H4461-057 | 5 | No | No | Yes |
| Humana Gold Plus H4461-058 (HMO) | H4461-058 | 5 | No | No | Yes |
| Humana Gold Plus H4461-059 (HMO) | H4461-059 | 5 | No | No | Yes |
| Humana Gold Plus H4461-060 (HMO) | H4461-060 | 5 | No | No | Yes |
| Humana Gold Plus H4461-061 (HMO) | H4461-061 | 5 | No | No | Yes |
| Humana Gold Plus H4461-062 (HMO) | H4461-062 | 5 | No | No | Yes |
| Humana Gold Plus H4461-073 (HMO) | H4461-073 | 5 | No | No | Yes |
| Humana Gold Plus H4461-078 (HMO) | H4461-078 | 5 | No | No | Yes |
| Humana Gold Plus H4461-079 (HMO) | H4461-079 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP) | H4461-038 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) | H4461-044 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP) | H4461-069 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-070 (HMO D-SNP) | H4461-070 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-071 (HMO D-SNP) | H4461-071 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP) | H4461-072 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) | H4461-074 | 5 | No | No | Yes |
| Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) | H4461-076 | 5 | No | No | Yes |
| Humana Total Complete Giveback H4461-047 (HMO-POS) | H4461-047 | 5 | No | No | Yes |
| Humana Total Complete H4461-043 (HMO) | H4461-043 | 5 | No | No | Yes |
| Humana Total Complete H4461-043 (HMO) | H4461-043 | 5 | No | No | Yes |
| Humana Total Complete H4461-046 (HMO) | H4461-046 | 5 | No | No | Yes |
| Humana Total Complete H4461-049 (HMO) | H4461-049 | 5 | No | No | Yes |
| Humana Total Complete H4461-051 (HMO) | H4461-051 | 5 | No | No | Yes |
| Humana Total Complete H4461-064 (HMO) | H4461-064 | 5 | No | No | Yes |
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.
Valtoco 5 MG Dose Kit 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.