Benefily
No prior authorization

Does Centene (WellCare) require prior authorization for Dilt?

Centene (WellCare) does not require prior authorization for Dilt 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 productPlans coveringRequire prior authStep therapyQty limitStatus
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Dilt]831215197 / 197000No prior authorization
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Dilt]831252197 / 197000No prior authorization
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Dilt]831285197 / 197000No prior authorization

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

Plan-by-plan detail — 24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Dilt]

Dilt has 3 products in the corpus; this table is for 24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Dilt], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellcare 'Ohana Dual Align (HMO-POS D-SNP)H9916-0012NoNoNo
Wellcare Assist (HMO-POS)H0913-0152NoNoNo
Wellcare Assist (HMO-POS)H1112-0432NoNoNo
Wellcare Assist (HMO-POS)H2491-0102NoNoNo
Wellcare Assist (HMO-POS)H4847-0052NoNoNo
Wellcare Assist (HMO-POS)H9730-0102NoNoNo
Wellcare Assist (HMO)H0174-0092NoNoNo
Wellcare Assist Open (PPO)H1914-0092NoNoNo
Wellcare Assist Open (PPO)H7326-0072NoNoNo
Wellcare CalViva Health Dual Align (HMO D-SNP)H3561-0072NoNoNo
Wellcare Classic (PDP)S4802-0123NoNoNo
Wellcare Classic (PDP)S4802-0133NoNoNo
Wellcare Classic (PDP)S4802-0143NoNoNo
Wellcare Classic (PDP)S4802-0203NoNoNo
Wellcare Classic (PDP)S4802-0213NoNoNo
Wellcare Classic (PDP)S4802-0693NoNoNo
Wellcare Classic (PDP)S4802-0703NoNoNo
Wellcare Classic (PDP)S4802-0713NoNoNo
Wellcare Classic (PDP)S4802-0723NoNoNo
Wellcare Classic (PDP)S4802-0733NoNoNo
Wellcare Classic (PDP)S4802-0743NoNoNo
Wellcare Classic (PDP)S4802-0753NoNoNo
Wellcare Classic (PDP)S4802-0763NoNoNo
Wellcare Classic (PDP)S4802-0773NoNoNo
Wellcare Classic (PDP)S4802-0783NoNoNo
Wellcare Classic (PDP)S4802-0793NoNoNo
Wellcare Classic (PDP)S4802-0803NoNoNo
Wellcare Classic (PDP)S4802-0813NoNoNo
Wellcare Classic (PDP)S4802-0823NoNoNo
Wellcare Classic (PDP)S4802-0833NoNoNo
Wellcare Classic (PDP)S4802-0843NoNoNo
Wellcare Classic (PDP)S4802-0853NoNoNo
Wellcare Classic (PDP)S4802-0863NoNoNo
Wellcare Classic (PDP)S4802-0873NoNoNo
Wellcare Classic (PDP)S4802-0883NoNoNo
Wellcare Classic (PDP)S4802-0893NoNoNo
Wellcare Classic (PDP)S4802-0903NoNoNo
Wellcare Classic (PDP)S4802-0913NoNoNo
Wellcare Classic (PDP)S4802-0923NoNoNo
Wellcare Classic (PDP)S4802-0933NoNoNo
Wellcare Classic (PDP)S4802-0943NoNoNo
Wellcare Classic (PDP)S4802-0953NoNoNo
Wellcare Classic (PDP)S4802-0963NoNoNo
Wellcare Classic (PDP)S4802-0973NoNoNo
Wellcare Dual Access (HMO D-SNP)H0174-0042NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0351-0662NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0351-0682NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H0712-0052NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1112-0062NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1112-0472NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H1862-0042NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H2491-0332NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H2491-0332NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H4073-0022NoNoNo
Wellcare Dual Access (HMO-POS D-SNP)H9364-0022NoNoNo
Wellcare Dual Access Open (PPO D-SNP)H0074-0042NoNoNo
Wellcare Dual Access Open (PPO D-SNP)H0111-0042NoNoNo
Wellcare Dual Access Open (PPO D-SNP)H4537-0042NoNoNo
Wellcare Dual Access Open (PPO D-SNP)H5965-0062NoNoNo
Wellcare Dual Access Open (PPO D-SNP)H7518-0032NoNoNo
Wellcare Dual Access Sync (HMO-POS D-SNP)H9730-0032NoNoNo
Wellcare Dual Access Sync Open (PPO D-SNP)H3975-0042NoNoNo
Wellcare Dual Liberty (HMO D-SNP)H0174-0062NoNoNo
Wellcare Dual Liberty (HMO D-SNP)H0712-0292NoNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H1112-0332NoNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H2491-0322NoNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H2491-0322NoNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H4073-0042NoNoNo
Wellcare Dual Liberty (HMO-POS D-SNP)H9364-0032NoNoNo
Wellcare Dual Liberty Open (PPO D-SNP)H1914-0082NoNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0232NoNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0242NoNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0252NoNoNo
Wellcare Dual Liberty Sync (HMO D-SNP)H0174-0262NoNoNo
Wellcare Dual Liberty Sync (HMO-POS D-SNP)H1862-0032NoNoNo
Wellcare Dual Liberty Sync (HMO-POS D-SNP)H9730-0042NoNoNo
Wellcare Dual Liberty Sync Open (PPO D-SNP)H5965-0042NoNoNo
Wellcare Dual Reserve (HMO D-SNP)H0174-0222NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1112-0462NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1112-0482NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H1862-0062NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H2491-0252NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H4073-0032NoNoNo
Wellcare Dual Reserve (HMO-POS D-SNP)H9730-0112NoNoNo
Wellcare Fidelis Dual Align (HMO D-SNP)H0913-0132NoNoNo
Wellcare Giveback (HMO-POS)H0712-0322NoNoNo
Wellcare Giveback (HMO-POS)H0913-0212NoNoNo
Wellcare Giveback (HMO-POS)H1112-0422NoNoNo
Wellcare Giveback (HMO-POS)H2491-0312NoNoNo
Wellcare Giveback (HMO-POS)H4847-0072NoNoNo
Wellcare Giveback (HMO-POS)H9364-0042NoNoNo
Wellcare Giveback (HMO-POS)H9730-0072NoNoNo
Wellcare Giveback (HMO)H0174-0172NoNoNo
Wellcare Giveback (HMO)H0174-0182NoNoNo
Wellcare Giveback (HMO)H0174-0192NoNoNo
Wellcare Giveback (HMO)H0174-0202NoNoNo
Wellcare Giveback (HMO)H0174-0212NoNoNo
Wellcare Giveback (HMO)H0351-0542NoNoNo
Wellcare Giveback (HMO)H0351-0642NoNoNo
Wellcare Giveback (HMO)H5087-0322NoNoNo
Showing 100 of 197 covering plans.
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.

Dilt at other payers

Or see Dilt 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.