Does Optimum Healthcare, INC. require prior authorization for Valtoco 5 MG Dose Kit?
Optimum Healthcare, INC. 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 | 15 / 15 | 0 | 0 | 15 | 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 |
|---|---|---|---|---|---|
| Optimum Diamond (HMO C-SNP) | H5594-036 | 3 | No | No | Yes |
| Optimum Diamond Rewards (HMO C-SNP) | H5594-028 | 3 | No | No | Yes |
| Optimum Diamond Rewards (HMO C-SNP) | H5594-034 | 3 | No | No | Yes |
| Optimum Diamond Rewards COPD (HMO C-SNP) | H5594-029 | 3 | No | No | Yes |
| Optimum Diamond Rewards COPD (HMO C-SNP) | H5594-035 | 3 | No | No | Yes |
| Optimum Diamond Savings (HMO C-SNP) | H5594-030 | 3 | No | No | Yes |
| Optimum Diamond Savings COPD (HMO C-SNP) | H5594-031 | 3 | No | No | Yes |
| Optimum Emerald Full (HMO D-SNP) | H5594-017 | 3 | No | No | Yes |
| Optimum Emerald Partial (HMO D-SNP) | H5594-016 | 3 | No | No | Yes |
| Optimum Gold Plan (HMO) | H5594-019 | 3 | No | No | Yes |
| Optimum Gold Plus Plan (HMO) | H5594-032 | 3 | No | No | Yes |
| Optimum Gold Rewards Plan (HMO) | H5594-001 | 3 | No | No | Yes |
| Optimum Gold Rewards Plan (HMO) | H5594-022 | 3 | No | No | Yes |
| Optimum Gold Rewards Plan (HMO) | H5594-026 | 3 | No | No | Yes |
| Optimum Platinum Plan (HMO) | H5594-002 | 3 | No | No | Yes |
- 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.