10 Mg/Ml Base Equiv

Generic: caffeine citrate

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 17 hours, 23 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 17 hours, 23 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026 via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None

UnitedHealthcare

13 plans

Source: PDF · Formulary date: Jun 23, 2026 · Checked: 17 hours, 23 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Bronze Standard+ Dental + Vision (No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Gold Standard (No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Silver Standard (No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Bronze Standard (No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) via caffeine citrate	Tier 1 - Preferred Generic	—	—	—	None