Bactrim
Generic: sulfamethoxazole-trimethoprim
80MG — Tablet
Also known as:
BACTRIM TAB 400-80MG
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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.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via sulfamethoxazole-trimethoprim |
Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield Federal
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Generic | — | — | — | None |
|
BCBS Federal Standard Option 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Generic | — | — | — | None |
|
BCBS Federal Basic Option 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Generic | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
| BCBS Federal Standard Option 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Value 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Value 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Care 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Local 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Preferred Generic | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Preferred Generic | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via sulfamethoxazole-trimethoprim |
Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |