Benefily
Prior authorization required

Does Mcs Advantage, INC. require prior authorization for Valtoco 5 MG Dose Kit?

Mcs Advantage, INC. requires prior authorization for Valtoco 5 MG Dose Kit on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
{1 (0.1 ML) (diazepam 50 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]227263020 / 2020020Prior authorization required

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]

PlanContractTierPrior authStep therapyQty limit
MCS Classicare Efectivo (HMO)H5577-0055YesNoYes
MCS Classicare En Tu Hogar (HMO)H5577-0435YesNoYes
MCS Classicare Essential (HMO-POS)H5577-0085YesNoYes
MCS Classicare Estrella (HMO)H5577-0605YesNoYes
MCS Classicare Excede (HMO)H5577-0565YesNoYes
MCS Classicare Excede (HMO)H5577-0565YesNoYes
MCS Classicare Excede (HMO)H5577-0565YesNoYes
MCS Classicare Firme (HMO)H5577-0425YesNoYes
MCS Classicare Hero (HMO)H5577-0445YesNoYes
MCS Classicare InteliCare (HMO)H5577-0525YesNoYes
MCS Classicare Platino 185 (HMO D-SNP)H5577-0625YesNoYes
MCS Classicare Platino Ideal (HMO D-SNP)H5577-0025YesNoYes
MCS Classicare Platino Maximo (HMO D-SNP)H5577-0545YesNoYes
MCS Classicare Platino Maximo (HMO D-SNP)H5577-0545YesNoYes
MCS Classicare Platino Maximo (HMO D-SNP)H5577-0545YesNoYes
MCS Classicare Platino Progreso (HMO D-SNP)H5577-0175YesNoYes
MCS Classicare Platino Superior (HMO D-SNP)H5577-0615YesNoYes
MCS Classicare Platino Total (HMO D-SNP)H5577-0465YesNoYes
MCS Classicare Primero (HMO C-SNP)H5577-0385YesNoYes
MCS Classicare RxMax (HMO)H5577-0595YesNoYes
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

Or see Valtoco 5 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.