Benefily
Varies by plan

Does HMO Colorado, INC. require prior authorization for Dilantin?

Prior authorization for Dilantin differs across HMO Colorado, INC.'s Medicare Part D plans and product strengths — 3 of 4 Dilantin 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 productPlans coveringRequire prior authStep therapyQty limitStatus
phenytoin 25 MG/ML Oral Suspension [Dilantin]13138840 / 10000Not on formulary
phenytoin 50 MG Chewable Tablet [Dilantin]13138875 / 10500Prior authorization required
phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]85567310 / 101000Prior authorization required
phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin]85587110 / 101000Prior authorization required

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

Plan-by-plan detail — phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]

Dilantin has 4 products in the corpus; this table is for phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Dual Advantage (HMO D-SNP)H4346-0144YesNoNo
Anthem Full Dual Advantage (HMO D-SNP)H4346-0254YesNoNo
Anthem Full Dual Advantage 2 (HMO D-SNP)H4346-0314YesNoNo
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H4346-0064YesNoNo
Anthem I CareMore Home Care (HMO I-SNP)H4346-0104YesNoNo
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H4346-0304YesNoNo
Anthem I CareMore Lung Care (HMO-POS C-SNP)H4346-0054YesNoNo
Anthem I CareMore Medicare Advantage (HMO-POS)H4346-0014YesNoNo
Anthem Medicare Advantage (HMO-POS)H4346-0174YesNoNo
Anthem Medicare Advantage (HMO)H4346-0124YesNoNo
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.

Dilantin at other payers

Or see Dilantin 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.