aficamten

10 mg, 15 mg, 20 mg, 5 mg — Tablet

Also known as: MYQORZO

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Myqorzo	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026 via Myqorzo	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Local 2026 via Myqorzo	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Care 2026 via Myqorzo	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Value 2026 via Myqorzo	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL

3 plans

Source: CMS QHP JSON · Formulary date: Sep 16, 2026 · Checked: 5 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Troy Medicare (HMO) via Myqorzo	Tier 5 - Specialty	✓	—	✓ 30 per 30 days	PA \| QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) via Myqorzo	Tier 5 - Specialty	✓	—	✓ 30 per 30 days	PA \| QL
AmeriHealth Caritas VIP Care (HMO D-SNP) via Myqorzo	Tier 5 - Specialty	✓	—	✓ 30 per 30 days	PA \| QL

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Myqorzo	Non-Preferred	—	—	—	None

3 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 54 minutes ago

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