Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Blue Cross Blue Shield Federal
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Basic Option 2026
via Brinsupri |
Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Brinsupri |
Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Advantage 2026
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
Medicare Part D
17 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
PruittHealth Premier (HMO I-SNP)
via Brinsupri |
Tier 1 - Preferred Generic | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Brinsupri |
Tier 1 - Preferred Generic | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via Brinsupri |
Tier 1 - Preferred Generic | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
NHC Advantage (HMO I-SNP)
via Brinsupri |
Tier 1 - Preferred Generic | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Wellcare Dual Liberty (HMO-POS D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Senior Care (HMO I-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Wellcare Simple Open (PPO)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Wellcare Simple (HMO-POS)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Wellcare Giveback Open (PPO)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Troy Medicare (HMO)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Wellcare Dual Liberty Open (PPO D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Wellcare Assist Open (PPO)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Wellcare Dual Access (HMO-POS D-SNP)
via Brinsupri |
Tier 5 - Specialty | ✓ | — | — | PA |