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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.
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Medicare Part D
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Troy Medicare (HMO)
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Cibinqo |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via Cibinqo |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via Cibinqo |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Cibinqo |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |