Benefily
No prior authorization

Does Health Care Service Corporation require prior authorization for Diacomit?

Health Care Service Corporation does not require prior authorization for Diacomit 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
stiripentol 250 MG Oral Capsule [Diacomit]205497931 / 31000No prior authorization
stiripentol 500 MG Oral Capsule [Diacomit]205498331 / 31000No prior authorization
stiripentol 500 MG Powder for Oral Suspension [Diacomit]205501431 / 31000No prior authorization
stiripentol 250 MG Powder for Oral Suspension [Diacomit]205501631 / 31000No prior authorization

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.

PlanContractTierPrior authStep therapyQty limit
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP)H8634-0091NoNoNo
Blue Cross Medicare Advantage Balance (PPO)H8634-0315NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0015NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0025NoNoNo
Blue Cross Medicare Advantage Basic (HMO)H3822-0125NoNoNo
Blue Cross Medicare Advantage Basic Plus (HMO-POS)H3822-0075NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H0107-0055NoNoNo
Blue Cross Medicare Advantage Choice Plus (PPO)H8634-0035NoNoNo
Blue Cross Medicare Advantage Choice Premier (PPO)H8634-0045NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H0107-0035NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0085NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0105NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0225NoNoNo
Blue Cross Medicare Advantage Classic (PPO)H8634-0275NoNoNo
Blue Cross Medicare Advantage Complete (PPO)H8634-0235NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H0107-0075NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0215NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0245NoNoNo
Blue Cross Medicare Advantage Dental Premier (PPO)H8634-0295NoNoNo
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)H3251-0291NoNoNo
Blue Cross Medicare Advantage Essential (PPO)H8634-0125NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H0107-0105NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0185NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0255NoNoNo
Blue Cross Medicare Advantage Health Choice (PPO)H8634-0305NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H0107-0045NoNoNo
Blue Cross Medicare Advantage Optimum (PPO)H8634-0325NoNoNo
Blue Cross Medicare Advantage Preferred (PPO)H8634-0335NoNoNo
Blue Cross Medicare Advantage Premier Plus (HMO-POS)H3822-0085NoNoNo
Blue Cross Medicare Advantage Select (HMO)H3251-0025NoNoNo
Blue Cross Medicare Advantage Value (HMO)H3822-0145NoNoNo
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.