Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via glycerin |
Tier 1 - Preferred Generic | — | — | — | None |
TRICARE
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
TRICARE Uniform Formulary 2026
via Biotrue Hydration Boost |
Tier 3 - Non-Formulary | — | — | — | None |
| TRICARE Uniform Formulary 2026 | Tier 3 - Non-Formulary | — | — | — | None |
|
TRICARE Uniform Formulary 2026
via Clear Eyes Nighttime |
Tier 3 - Non-Formulary | — | — | — | None |