Adthyza

Generic: thyroid (USP)

16.25MG, 30MG, 32.5MG, 60MG, 65MG, 90MG, 97.5MG, 120MG, 130MG — Tablet

Also known as: thyroid (USP) ADTHYZA TABS 16.25MG, 30MG, 32.5MG, 60MG, 65MG, 90MG, 97.5MG, 120MG, 130MG ADTHYZA TABS 16.25MG, 30MG, 32.5MG,

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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.

Ambetter (Centene)

58 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Elite Bronze via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Silver with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Standard Gold with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Complete Gold via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Expanded Bronze via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Silver via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Gold via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Expanded Bronze with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Silver with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Gold with Atrium Health via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Expanded Bronze + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Silver + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Gold + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Silver with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Standard Gold with Atrium Health + Vision + Adult Dental via NP Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold	Tier 3 - Preferred Brand	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options	Tier 3 - Preferred Brand	—	—	—	None
Everyday Bronze	Tier 3 - Preferred Brand	—	—	—	None
Elite Bronze	Tier 3 - Preferred Brand	—	—	—	None
Clear Silver with $0 Insulin Options	Tier 3 - Preferred Brand	—	—	—	None
Standard Expanded Bronze	Tier 3 - Preferred Brand	—	—	—	None
Standard Silver	Tier 3 - Preferred Brand	—	—	—	None
Standard Gold	Tier 3 - Preferred Brand	—	—	—	None
Everyday Bronze with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Elite Bronze with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Focused Silver with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Complete Gold with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Standard Expanded Bronze with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Standard Silver with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Standard Gold with Atrium Health	Tier 3 - Preferred Brand	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Complete Gold + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Everyday Bronze + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Elite Bronze + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Standard Expanded Bronze + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Standard Silver + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Standard Gold + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 3 - Preferred Brand	—	—	—	None

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via NP Thyroid	Tier 1 - Generic	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Not Covered	—	—	—	None

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via NP Thyroid	Tier 4 - Higher Cost	—	—	—	None