Benefily
No prior authorization

Does Hcsc Insurance Services Company require prior authorization for Valtoco 15 MG Dose Kit?

Hcsc Insurance Services Company does not require prior authorization for Valtoco 15 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 productPlans coveringRequire prior authStep therapyQty limitStatus
{2 (0.1 ML) (diazepam 75 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 15 MG Dose Kit]227263618 / 180018No prior authorization

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

Plan-by-plan detail — {2 (0.1 ML) (diazepam 75 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 15 MG Dose Kit]

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

Or see Valtoco 15 MG Dose Kit 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.