abatacept

Generic: Orencia

125 mg/mL, 50 mg/0.4 mL, 87.5 mg/0.7 mL — Prefilled Syringe

TARGETED IMMUNOMODULATORY BIOLOGICS

Also known as: ORENCIA CLICKJECT ORENCIA
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 6 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026
via Orencia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Local 2026
via Orencia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Care 2026
via Orencia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Value 2026
via Orencia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Advantage 2026
via Orencia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 6 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via Orencia 		Tier 4 - Specialty ✓ — ✓ Specialty Pharmacy Required PA | QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 6 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.80 per 28 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.80 per 28 days PA | QL
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.80 per 28 days PA | QL
NHC Advantage (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.8 per 28 days PA | QL
PruittHealth Premier (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.8 per 28 days PA | QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.8 per 28 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP)
via Orencia 		Tier 1 - Preferred Generic ✓ — ✓ 2.8 per 28 days PA | QL
Blue Medicare Essential (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Experience Health Medicare Advantage (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthTeam Advantage Plan I (PPO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.80 per 28 days PA | QL
HealthTeam Advantage Plan II (PPO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.80 per 28 days PA | QL
HealthTeam Advantage Vitality Plan (PPO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.80 per 28 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.80 per 28 days PA | QL
Troy Medicare (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Senior Care (HMO I-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring True Choice (PPO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring TotalCare (HMO D-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring Preferred (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring Preferred Select (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring Preferred Savings (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
HealthSpring Preferred Plus (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Liberty Medicare Advantage (HMO C-SNP)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Blue Medicare PPO Enhanced (PPO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Blue Medicare Essential Plus (HMO-POS)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Blue Medicare Enhanced (HMO-POS)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Blue Medicare Choice (HMO)
via Orencia 		Tier 5 - Specialty ✓ — ✓ 2.8 per 28 days PA | QL
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 6 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — ✓ PA | QL
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