Does Wellpoint Texas, INC. require prior authorization for Valtoco 5 MG Dose Kit?
Wellpoint Texas, 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 | 16 / 16 | 0 | 0 | 16 | 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 |
|---|---|---|---|---|---|
| Wellpoint Chronic Care 2 (HMO-POS C-SNP) | H2593-006 | 4 | No | No | Yes |
| Wellpoint Dual Advantage 2 (HMO D-SNP) | H2593-032 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage (HMO D-SNP) | H2593-053 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | H2593-048 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | H2593-051 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | H2593-044 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | H2593-045 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | H2593-046 | 4 | No | No | Yes |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | H2593-047 | 4 | No | No | Yes |
| Wellpoint I CareMore Home Care 2 (HMO I-SNP) | H2593-003 | 4 | No | No | Yes |
| Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) | H2593-040 | 4 | No | No | Yes |
| Wellpoint Kidney Care (HMO-POS C-SNP) | H2593-031 | 4 | No | No | Yes |
| Wellpoint Kidney Care (HMO-POS C-SNP) | H2593-043 | 4 | No | No | Yes |
| Wellpoint Lung Care 2 (HMO-POS C-SNP) | H2593-005 | 4 | No | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H2593-001 | 4 | No | No | Yes |
| Wellpoint Medicare Advantage 2 (HMO-POS) | H2593-029 | 4 | 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.