Aricept

Generic: donepezil

5MG, 10MG, 23MG — Tablet

Also known as: ARICEPT TABS 5MG, 10MG, 23MG

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

2 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Basic Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Local 2026	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Care 2026	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Value 2026	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Advantage 2026	Tier 1 - Lowest Cost Generic	—	—	✓	QL

2 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 30 minutes ago

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

3 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026	Tier 3 - Non-Preferred Brand	—	—	—	None