Bomyntra
Generic: denosumab-bnht
120MG/1.7ML — Prefilled Syringe
Also known as:
denosumab-bnht
BOMYNTRA SOLN 120MG/1.7ML; SOSY 120MG/1.7ML
BOMYNTRA SOLN 120MG/1.7ML; SOSY
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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.
Medicare Part D
30 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Conexxence |
Tier 1 - Preferred Generic | — | ✓ | ✓ 1 per 168 days | ST | QL |
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
|
Longevity Health Plan (HMO I-SNP)
via Conexxence |
Tier 1 - Preferred Generic | — | — | ✓ 1 per 180 days | QL |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via Conexxence |
Tier 1 - Preferred Generic | — | ✓ | ✓ 1 per 168 days | ST | QL |
|
NHC Advantage (HMO I-SNP)
via Conexxence |
Tier 1 - Preferred Generic | — | ✓ | ✓ 1 per 168 days | ST | QL |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
|
PruittHealth Premier (HMO I-SNP)
via Conexxence |
Tier 1 - Preferred Generic | — | ✓ | ✓ 1 per 168 days | ST | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
|
Senior Care (HMO I-SNP)
via Conexxence |
Tier 3 - Preferred Brand | — | ✓ | ✓ 1 per 168 days | ST | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via Conexxence |
Tier 3 - Preferred Brand | — | ✓ | ✓ 1 per 168 days | ST | QL |
|
Wellcare Dual Access (HMO-POS D-SNP)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Assist Open (PPO)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Giveback Open (PPO)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Dual Liberty Open (PPO D-SNP)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Simple Open (PPO)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Simple (HMO-POS)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
|
Wellcare Dual Liberty (HMO-POS D-SNP)
via Conexxence |
Tier 4 - Non-Preferred | — | — | ✓ 1 per 180 days | QL |
| Senior Care (HMO I-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 1.7 per 28 days | PA | QL |
| Wellcare Simple Open (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Simple (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Giveback Open (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Assist Open (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
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 | Not Covered | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |