No prior authorization
Does Humana require prior authorization for Valtoco 5 MG Dose Kit?
Humana does not require prior authorization for Valtoco 5 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 product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| {1 (0.1 ML) (diazepam 50 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]2272630 | 817 / 817 | 0 | 0 | 817 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — {1 (0.1 ML) (diazepam 50 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | S5884-101 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-102 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-103 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-104 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-105 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-106 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-107 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-108 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-109 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-110 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-111 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-112 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-113 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-114 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-115 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-116 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-131 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-132 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-133 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-134 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-135 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-136 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-137 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-138 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-139 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-140 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-141 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-142 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-143 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-144 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-145 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-146 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-147 | 5 | No | No | Yes |
| Humana Basic Rx Plan (PDP) | S5884-216 | 5 | No | No | Yes |
| Humana Cleveland Clinic Preferred (HMO-POS) | H6622-023 | 5 | No | No | Yes |
| Humana Community (HMO-POS) | H4623-002 | 5 | No | No | Yes |
| Humana Community (HMO) | H0292-001 | 5 | No | No | Yes |
| Humana Community (HMO) | H1036-236 | 5 | No | No | Yes |
| Humana Community (HMO) | H1036-332 | 5 | No | No | Yes |
| Humana Community (HMO) | H5178-002 | 5 | No | No | Yes |
| Humana Community (HMO) | H5619-159 | 5 | No | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1036-234 | 5 | No | No | Yes |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1468-017 | 5 | No | No | Yes |
| Humana Community HMO SNP-DE (HMO D-SNP) | H1036-235 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-406 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-424 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-431 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5216-452 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H5970-031 | 5 | No | No | Yes |
| Humana Direct Choice Giveback (PPO) | H7617-112 | 5 | No | No | Yes |
| Humana Direct Choice GIveback (PPO) | H5970-032 | 5 | No | No | Yes |
| Humana Dual Fully Integrated (HMO D-SNP) | H4329-001 | 5 | No | No | Yes |
| Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) | H2875-001 | 5 | No | No | Yes |
| Humana Dual Fully Integrated H2875-003 (HMO D-SNP) | H2875-003 | 5 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H0963-001 | 5 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-339 | 5 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-340 | 5 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1036-341 | 5 | No | No | Yes |
| Humana Dual Integrated (HMO D-SNP) | H1396-001 | 5 | No | No | Yes |
| Humana Dual Select H0028-078 (HMO D-SNP) | H0028-078 | 5 | No | No | Yes |
| Humana Dual Select H0028-079 (HMO D-SNP) | H0028-079 | 5 | No | No | Yes |
| Humana Dual Select H1036-307 (HMO D-SNP) | H1036-307 | 5 | No | No | Yes |
| Humana Dual Select H1036-329 (HMO D-SNP) | H1036-329 | 5 | No | No | Yes |
| Humana Dual Select H1951-056 (HMO D-SNP) | H1951-056 | 5 | No | No | Yes |
| Humana Dual Select H2875-005 (HMO D-SNP) | H2875-005 | 5 | No | No | Yes |
| Humana Dual Select H2875-006 (HMO-POS D-SNP) | H2875-006 | 5 | No | No | Yes |
| Humana Dual Select H4939-002 (HMO-POS D-SNP) | H4939-002 | 5 | No | No | Yes |
| Humana Dual Select H5216-206 (PPO D-SNP) | H5216-206 | 5 | No | No | Yes |
| Humana Dual Select H5216-298 (PPO D-SNP) | H5216-298 | 5 | No | No | Yes |
| Humana Dual Select H5216-361 (PPO D-SNP) | H5216-361 | 5 | No | No | Yes |
| Humana Dual Select H5216-385 (PPO D-SNP) | H5216-385 | 5 | No | No | Yes |
| Humana Dual Select H5525-046 (PPO D-SNP) | H5525-046 | 5 | No | No | Yes |
| Humana Dual Select H5525-072 (PPO D-SNP) | H5525-072 | 5 | No | No | Yes |
| Humana Dual Select H5619-075 (HMO D-SNP) | H5619-075 | 5 | No | No | Yes |
| Humana Dual Select H5619-093 (HMO D-SNP) | H5619-093 | 5 | No | No | Yes |
| Humana Dual Select H5619-126 (HMO-POS D-SNP) | H5619-126 | 5 | No | No | Yes |
| Humana Dual Select H5619-165 (HMO D-SNP) | H5619-165 | 5 | No | No | Yes |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | H6622-027 | 5 | No | No | Yes |
| Humana Dual Select H7617-039 (PPO D-SNP) | H7617-039 | 5 | No | No | Yes |
| Humana Dual Select H7617-074 (PPO D-SNP) | H7617-074 | 5 | No | No | Yes |
| Humana Dual Select H7617-083 (PPO D-SNP) | H7617-083 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H0028-063 (HMO) | H0028-063 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H1036-271 (HMO) | H1036-271 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-308 (PPO) | H5216-308 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-358 (PPO) | H5216-358 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-405 (PPO) | H5216-405 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-429 (PPO) | H5216-429 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-430 (PPO) | H5216-430 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H5216-435 (PPO) | H5216-435 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-017 (PPO) | H7617-017 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-024 (PPO) | H7617-024 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-035 (PPO) | H7617-035 | 5 | No | No | Yes |
| Humana Essentials Plus Giveback H7617-100 (PPO) | H7617-100 | 5 | No | No | Yes |
| Humana FMOL Baton Rouge H1951-053 (HMO) | H1951-053 | 5 | No | No | Yes |
| Humana Full Access Giveback H5216-306 (PPO) | H5216-306 | 5 | No | No | Yes |
| Humana Full Access Giveback H5216-311 (PPO) | H5216-311 | 5 | No | No | Yes |
| Humana Full Access Giveback H5216-393 (PPO) | H5216-393 | 5 | No | No | Yes |
| Humana Full Access Giveback H7617-058 (PPO) | H7617-058 | 5 | No | No | Yes |
Showing 100 of 817 covering plans.
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 5 MG Dose Kit at other payers
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.