acarbose
25 mg, 50 mg, 100 mg — Tablet
Also known as:
acarbose oral
Precose
acarbose tabs 25mg, 50mg, 100mg
acarbose tab 25 mg, 50 mg, 100 mg
Acarbose 100 Mg Tablet
Acarbose 25 Mg Tablet
Acarbose 50 Mg Tablet
Acarbose Oral Tablet
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Gold | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Gold with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Silver with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Expanded Bronze with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver $0 Rx Options | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold | Tier 2 - Generic | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Expanded Bronze | Tier 2 - Generic | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Signature Silver | Tier 2 - Generic | — | — | ✓ | QL |
| Streamlined Silver with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Streamlined Silver | Tier 2 - Generic | — | — | ✓ | QL |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
AmeriHealth Caritas NC
11 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 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 |
| BCBSNC Blue Local 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Silver RD 5000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver 5000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver 3600 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 2 - Generic | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 2 - Generic | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 2 - Generic | — | — | — | None |
Medicare Part D
140 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5216-211 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Humana Full Access H5525-034 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-049 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-050 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-070 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-083 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Signature (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Erickson Advantage Freedom (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Erickson Advantage Liberty (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthSpring True Choice (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| Humana Gold Choice H8145-004 (PFFS) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthSpring TotalCare (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthSpring Preferred (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthSpring Preferred Select (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthSpring Preferred Savings (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthSpring Preferred Plus (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 360 per 30 days | QL |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 2 - Generic | — | — | — | None |
| Aetna Medicare Dual (HMO D-SNP) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Alignment Health AVA (PPO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Healthy Blue + Medicare (HMO-POS D-SNP) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| DEVOTED CHOICE 001 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE 003 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE 005 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE 008 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 2 - Generic | — | — | — | None |
| HealthTeam Advantage Plan I (PPO) | Tier 2 - Generic | — | — | — | None |
| HealthTeam Advantage Plan II (PPO) | Tier 2 - Generic | — | — | — | None |
| Aetna Medicare Signature (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 2 - Generic | — | — | — | None |
| DEVOTED CORE 001 NC (HMO) | Tier 2 - Generic | — | — | — | None |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Alignment Health Platinum Select (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Alignment Health smartHMO (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Alignment Health Platinum (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Troy Medicare (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Senior Care (HMO I-SNP) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Experience Health Medicare Advantage (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Blue Medicare Essential (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Blue Medicare Choice (HMO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Blue Medicare Enhanced (HMO-POS) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Blue Medicare Essential Plus (HMO-POS) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| Aetna Medicare Signature (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature Giveback (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Blue Medicare PPO Enhanced (PPO) | Tier 2 - Generic | — | — | ✓ 360 per 30 days | QL |
| Aetna Medicare Enhanced (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Signature Care (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Prime (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Aetna Medicare Value Plus (HMO) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 2 - Generic | — | — | ✓ 90 per 30 days | QL |
| Wellcare Assist Open (PPO) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Simple (HMO-POS) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 6 - Specialty Plus | — | — | — | None |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 6 - Specialty Plus | — | — | — | None |
| Wellcare Giveback Open (PPO) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Simple Open (PPO) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 6 - Specialty Plus | — | — | ✓ 360 per 30 days | QL |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Secure | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| AIAN Cost Share | Tier 2 - Generic | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 2 - Generic | — | — | — | None |
| Silver Classic | Tier 2 - Generic | — | — | — | None |
| Secure | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | Tier 2 - Generic | — | — | — | None |
| Gold Elite Saver Plus | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | Tier 2 - Generic | — | — | — | None |
UnitedHealthcare
17 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Bronze Standard (HSA, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 1 - Preferred Generic | — | — | ✓ | QL |
| UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |