Benefily
No prior authorization

Does Hcsc Insurance Services Company require prior authorization for Lokelma?

Hcsc Insurance Services Company does not require prior authorization for Lokelma 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
sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]204763918 / 18000No prior authorization
sodium zirconium cyclosilicate 10000 MG Powder for Oral Suspension [Lokelma]205392718 / 18000No prior authorization

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

Plan-by-plan detail — sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]

Lokelma has 2 products in the corpus; this table is for sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Cross Medicare Advantage Access (PPO)H1666-0213NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0193NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0233NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0063NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0083NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0033NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0123NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H1666-0163NoNoNo
Blue Cross Medicare Advantage Dental Value (HMO)H9706-0073NoNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H9706-0021NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H1666-0143NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0203NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0223NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0243NoNoNo
Blue Cross Medicare Advantage Saver (HMO)H9706-0083NoNoNo
Blue Cross Medicare Advantage Secure (HMO)H9706-0053NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0013NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0093NoNoNo
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.

Lokelma at other payers

Or see Lokelma 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.