No prior authorization

Does Mmm Healthcare, LLC require prior authorization for Dificid?

Mmm Healthcare, LLC does not require prior authorization for Dificid on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

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.
No prior authorization is filed, but step therapy applies on 20 of 20 covering plans — the plan requires another drug be tried first.

By product strength

RxNorm product	Plans covering	Require prior auth	Step therapy	Qty limit	Status
fidaxomicin 200 MG Oral Tablet [Dificid]1111110	0 / 20	0	0	0	Not on formulary
fidaxomicin 40 MG/ML Oral Suspension [Dificid]2279847	20 / 20	0	20	0	No prior authorization

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

Plan-by-plan detail — fidaxomicin 40 MG/ML Oral Suspension [Dificid]

Dificid has 2 products in the corpus; this table is for fidaxomicin 40 MG/ML Oral Suspension [Dificid], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
MMM Balance (HMO-POS)	H4004-073	6	No	Yes	No
MMM Balance (HMO-POS)	H4004-073	6	No	Yes	No
MMM Balance (HMO-POS)	H4004-073	6	No	Yes	No
MMM Combo Platino (HMO D-SNP)	H4004-068	6	No	Yes	No
MMM Deluxe (HMO-POS)	H4003-055	6	No	Yes	No
MMM Diamante Platino (HMO D-SNP)	H4003-017	6	No	Yes	No
MMM Dorado Platino (HMO D-SNP)	H4003-058	6	No	Yes	No
MMM Elite (HMO-POS)	H4003-034	6	No	Yes	No
MMM Flexi Platino (HMO D-SNP)	H4004-069	6	No	Yes	No
MMM Grandioso (HMO-POS)	H4004-070	6	No	Yes	No
MMM Mega Flex (HMO-POS)	H4004-071	6	No	Yes	No
MMM Plenitud (HMO-POS)	H4004-065	6	No	Yes	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	No	Yes	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	No	Yes	No
MMM Relax Platino (HMO D-SNP)	H4004-072	6	No	Yes	No
MMM Supremo (HMO C-SNP)	H4003-009	6	No	Yes	No
MMM Unico (HMO-POS)	H4003-019	6	No	Yes	No
MMM Valioso (HMO-POS)	H4004-066	6	No	Yes	No
PMC Max (HMO-POS)	H4004-056	6	No	Yes	No
PMC Premier Platino (HMO D-SNP)	H4004-048	6	No	Yes	No

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.

Dificid at other payers

Or see Dificid 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.