Does Pacificsource Community Health Plans require prior authorization for Dificid?
Pacificsource Community Health Plans 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 11 of 11 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 / 11 | 0 | 0 | 0 | Not on formulary |
| fidaxomicin 40 MG/ML Oral Suspension [Dificid]2279847 | 11 / 11 | 0 | 11 | 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 |
|---|---|---|---|---|---|
| PacificSource Dual Care (HMO D-SNP) | H3864-043 | 5 | No | Yes | No |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | H3864-014 | 5 | No | Yes | No |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | H3864-036 | 5 | No | Yes | No |
| PacificSource Medicare Essentials Rx 27 (HMO) | H3864-027 | 5 | No | Yes | No |
| PacificSource Medicare Essentials Rx 41 (HMO) | H3864-041 | 5 | No | Yes | No |
| PacificSource Medicare Essentials Rx 6 (HMO) | H3864-006 | 5 | No | Yes | No |
| PacificSource Medicare Explorer Rx 4 (PPO) | H4754-004 | 5 | No | Yes | No |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | H3864-024 | 5 | No | Yes | No |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | H3864-029 | 5 | No | Yes | No |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | H3864-034 | 5 | No | Yes | No |
| PacificSource Medicare MyCare Rx 40 (HMO) | H3864-040 | 5 | No | Yes | No |
- 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
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.