Benefily
Prior authorization required

Does Qcc Insurance Company require prior authorization for Valtoco 15 MG Dose Kit?

Qcc Insurance Company requires prior authorization for Valtoco 15 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
{2 (0.1 ML) (diazepam 75 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 15 MG Dose Kit]22726364 / 4404Prior authorization required

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

Plan-by-plan detail — {2 (0.1 ML) (diazepam 75 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 15 MG Dose Kit]

PlanContractTierPrior authStep therapyQty limit
Personal Choice 65 Achieve Rx (PPO)H3909-0205YesNoYes
Personal Choice 65 Plus Rx (PPO)H3909-0185YesNoYes
Personal Choice 65 Rx (PPO)H3909-0015YesNoYes
Personal Choice 65 Rx (PPO)H3909-0095YesNoYes
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 15 MG Dose Kit at other payers

Or see Valtoco 15 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.