Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
68 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Complete Gold
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Everyday Bronze
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Elite Bronze
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Clear Silver with $0 Insulin Options
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Expanded Bronze
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Silver
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Gold
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Everyday Bronze with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Elite Bronze with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Focused Silver with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Complete Gold with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Expanded Bronze with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Silver with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Gold with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Complete Gold + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Everyday Bronze + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Elite Bronze + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Expanded Bronze + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Silver + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Gold + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Streamlined Silver with Atrium Health
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Streamlined Silver
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via betamethasone dipropionate |
Tier 2 - Generic | — | ✓ | — | ST |
| Complete Gold | Tier 2 - Generic | — | ✓ | — | ST |
| Enhanced Asthma/COPD Care Silver $0 Rx Options | Tier 2 - Generic | — | ✓ | — | ST |
| Everyday Bronze | Tier 2 - Generic | — | ✓ | — | ST |
| Elite Bronze | Tier 2 - Generic | — | ✓ | — | ST |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Expanded Bronze | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Silver | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Gold | Tier 2 - Generic | — | ✓ | — | ST |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Complete Gold with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Expanded Bronze with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Silver with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Gold with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Silver + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Gold + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 2 - Generic | — | ✓ | — | ST |
| Streamlined Silver with Atrium Health | Tier 2 - Generic | — | ✓ | — | ST |
| Streamlined Silver | Tier 2 - Generic | — | ✓ | — | ST |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | ✓ | — | ST |
AmeriHealth Caritas NC
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
Blue Cross Blue Shield Federal
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Standard Option 2026
via Enstilar |
Tier 3 - Non-Preferred Brand | — | — | ✓ | QL |
|
BCBS Federal Basic Option 2026
via Enstilar |
Tier 3 - Non-Preferred Brand | — | — | ✓ | QL |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Local 2026
via betamethasone dipropionate |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via betamethasone dipropionate |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via betamethasone dipropionate |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via betamethasone dipropionate |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via betamethasone dipropionate |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Enstilar |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Enstilar |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Enstilar |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Enstilar |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Enstilar |
Tier 3 - High Cost Brand | — | — | — | None |
Medicare Part D
19 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CORE 001 NC (HMO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED GIVEBACK 002 NC (HMO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED GIVEBACK 012 NC (HMO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE 001 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE 003 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE 005 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE 008 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 per 30 days | PA | QL |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Enstilar |
Tier 5 - Specialty | ✓ | — | ✓ 120 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 - HDHP 2026
via Enstilar |
Tier 2 - Non-Preferred Generic | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Enstilar |
Tier 2 - Non-Preferred Generic | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Enstilar |
Tier 2 - Non-Preferred Generic | ✓ | — | — | PA |
TRICARE
1 planUnitedHealthcare
17 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)
via betamethasone dipropionate |
Tier 4 - Non-Preferred | — | — | ✓ | QL |