Benefily
No prior authorization

Does Wellpoint Texas, INC. require prior authorization for Matzim?

Wellpoint Texas, INC. does not require prior authorization for Matzim 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 productPlans coveringRequire prior authStep therapyQty limitStatus
24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim]109162311 / 16000No prior authorization
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Tablet [Matzim]109162911 / 16000No prior authorization
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Tablet [Matzim]109163211 / 16000No prior authorization
24 HR diltiazem hydrochloride 300 MG Extended Release Oral Tablet [Matzim]109163511 / 16000No prior authorization
24 HR diltiazem hydrochloride 360 MG Extended Release Oral Tablet [Matzim]109163811 / 16000No prior authorization

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

Plan-by-plan detail — 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim]

Matzim has 5 products in the corpus; this table is for 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Tablet [Matzim], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Wellpoint Dual Advantage 2 (HMO D-SNP)H2593-0324NoNoNo
Wellpoint Full Dual Advantage (HMO D-SNP)H2593-0534NoNoNo
Wellpoint Full Dual Advantage 2 (HMO D-SNP)H2593-0484NoNoNo
Wellpoint Full Dual Advantage 2 (HMO D-SNP)H2593-0514NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0444NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0454NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0464NoNoNo
Wellpoint Full Dual Advantage Aligned (HMO D-SNP)H2593-0474NoNoNo
Wellpoint Kidney Care (HMO-POS C-SNP)H2593-0314NoNoNo
Wellpoint Kidney Care (HMO-POS C-SNP)H2593-0434NoNoNo
Wellpoint Medicare Advantage 2 (HMO-POS)H2593-0294NoNoNo
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.

Matzim at other payers

Or see Matzim 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.