Benefily
No prior authorization

Does Hcsc Insurance Services Company require prior authorization for Nicotrol?

Hcsc Insurance Services Company 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 productPlans coveringRequire prior authStep therapyQty limitStatus
nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol]179788818 / 18000No 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]

PlanContractTierPrior authStep therapyQty limit
Blue Cross Medicare Advantage Access (PPO)H1666-0214NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0194NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H1666-0234NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0064NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H1666-0084NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0034NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H1666-0124NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H1666-0164NoNoNo
Blue Cross Medicare Advantage Dental Value (HMO)H9706-0074NoNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H9706-0021NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H1666-0144NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0204NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0224NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H1666-0244NoNoNo
Blue Cross Medicare Advantage Saver (HMO)H9706-0084NoNoNo
Blue Cross Medicare Advantage Secure (HMO)H9706-0054NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0014NoNoNo
Blue Cross Medicare Advantage Value (HMO)H9706-0094NoNoNo
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.

Nicotrol at other payers

Or see Nicotrol 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.