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.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Orencia |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
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 |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Silver 4400 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 3500 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver 3500 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Gold RD CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Gold CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver CMS Standard
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect myDiabetesCare Silver
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 2200 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Gold 1500 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect myDiabetesCare Bronze
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 5500 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 6500 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver 3000 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 5000 Indiv Med Deductible
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Medicare Part D
30 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Provider Partners North Carolina Community 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 |
|
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 Essential Plan (HMO I-SNP)
via Orencia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 2.80 per 28 days | PA | QL |
|
HealthSpring True Choice (PPO)
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 |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
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 |
|
Troy Medicare (HMO)
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ 2.8 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 |
|
HealthTeam Advantage Vitality Plan (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 Plan I (PPO)
via Orencia |
Tier 5 - Specialty | ✓ | — | ✓ 2.80 per 28 days | PA | QL |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
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 |
|
Blue Medicare Essential (HMO)
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 |
|
Blue Medicare Enhanced (HMO-POS)
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 PPO Enhanced (PPO)
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 |
|
HealthSpring Preferred Plus (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 Select (HMO)
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 TotalCare Plus (HMO D-SNP)
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 |