Varies by plan

Does Harmony Health Plan, INC. require prior authorization for Diacomit?

Prior authorization for Diacomit differs across Harmony Health Plan, INC.'s Medicare Part D plans and product strengths — 3 of 4 Diacomit products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
stiripentol 250 MG Oral Capsule [Diacomit]2054979	19 / 19	19	19	Prior authorization required
stiripentol 500 MG Oral Capsule [Diacomit]2054983	19 / 19	19	19	Prior authorization required
stiripentol 500 MG Powder for Oral Suspension [Diacomit]2055014	19 / 19	19	19	Prior authorization required
stiripentol 250 MG Powder for Oral Suspension [Diacomit]2055016	0 / 19	0	0	Not on formulary

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

Plan-by-plan detail — stiripentol 250 MG Oral Capsule [Diacomit]

Diacomit has 4 products in the corpus; this table is for stiripentol 250 MG Oral Capsule [Diacomit], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Wellcare Assist (HMO-POS)	H1416-042	5	Yes	No	Yes
Wellcare Assist (HMO-POS)	H1416-068	5	Yes	No	Yes
Wellcare Assist (HMO-POS)	H1416-083	5	Yes	No	Yes
Wellcare Dual Access (HMO-POS D-SNP)	H1416-034	5	Yes	No	Yes
Wellcare Dual Access (HMO-POS D-SNP)	H1416-035	5	Yes	No	Yes
Wellcare Dual Access Harmony (HMO-POS D-SNP)	H1416-033	5	Yes	No	Yes
Wellcare Dual Liberty (HMO-POS D-SNP)	H1416-044	5	Yes	No	Yes
Wellcare Dual Liberty Nurture (HMO-POS D-SNP)	H1416-043	5	Yes	No	Yes
Wellcare Dual Reserve (HMO-POS D-SNP)	H1416-081	5	Yes	No	Yes
Wellcare Giveback (HMO-POS)	H1416-065	5	Yes	No	Yes
Wellcare Giveback (HMO-POS)	H1416-079	5	Yes	No	Yes
Wellcare Giveback Dividend (HMO-POS)	H1416-064	5	Yes	No	Yes
Wellcare Low Premium (HMO-POS)	H1416-026	5	Yes	No	Yes
Wellcare Simple (HMO-POS)	H1416-009	5	Yes	No	Yes
Wellcare Simple (HMO-POS)	H1416-071	5	Yes	No	Yes
Wellcare Simple (HMO-POS)	H1416-072	5	Yes	No	Yes
Wellcare Simple (HMO-POS)	H1416-077	5	Yes	No	Yes
Wellcare Simple Preferred (HMO-POS)	H1416-055	5	Yes	No	Yes
Wellcare Simple Value (HMO-POS)	H1416-082	5	Yes	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.

Diacomit at other payers

Or see Diacomit 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.