Bensal HP

Generic: salicylic acid

Ointment

Coverage by Insurer

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

Cigna

20 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 19 hours, 23 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Connect Bronze CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Silver via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Bronze via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Silver RD CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Gold CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None
Connect Gold RD CMS Standard via salicylic acid	Tier 2 - Generic	—	—	—	None

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 19 hours, 23 minutes ago

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