BromSite

Generic: bromfenac

075% — Solution

Anti-Inflammatory

Also known as: BROMSITE SOLN .075%
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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.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Focused Silver with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver $0 Rx Options
via bromfenac 		Tier 2 - Generic — — — None
Everyday Bronze
via bromfenac 		Tier 2 - Generic — — — None
Elite Bronze
via bromfenac 		Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options
via bromfenac 		Tier 2 - Generic — — — None
Signature Expanded Bronze
via bromfenac 		Tier 2 - Generic — — — None
Signature Silver
via bromfenac 		Tier 2 - Generic — — — None
Signature Gold
via bromfenac 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Signature Gold + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Signature Silver with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Signature Gold with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Complete Gold
via bromfenac 		Tier 2 - Generic — — — None
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Streamlined Silver
via bromfenac 		Tier 2 - Generic — — — None
Streamlined Silver with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Enhanced CHF Heart Care Silver $0 Rx Options
via bromfenac 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Signature Expanded Bronze with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Signature Silver with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Signature Gold with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Signature Expanded Bronze + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Signature Silver + Vision + Adult Dental
via bromfenac 		Tier 2 - Generic — — — None
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 4 hours, 33 minutes ago
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 bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Premier + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via bromfenac 		Tier 2 - Generic — ✓ — ST
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026
via Prolensa 		Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Standard Option 2026
via Prolensa 		Tier 3 - Non-Preferred Brand — — — None
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via bromfenac 		Tier 1 - Preferred Generic — — ✓ 12 per 365 days QL
Provider Partners North Carolina Community Plan (HMO I-SNP)
via bromfenac 		Tier 1 - Preferred Generic — — ✓ 12 per 365 days QL
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via bromfenac 		Tier 1 - Preferred Generic — — ✓ 12 per 365 days QL
Longevity Health Plan (HMO I-SNP)
via bromfenac 		Tier 1 - Preferred Generic — — — None
AmeriHealth Caritas VIP Care (HMO D-SNP)
via bromfenac 		Tier 2 - Generic — — — None
Alignment Health Platinum Select (HMO)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health AVA (PPO)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health AVA (PPO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health Platinum Select (HMO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health smartHMO (HMO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health NC Duals (HMO-POS D-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health Platinum (HMO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Dual Liberty (HMO-POS D-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Dual Reserve (HMO-POS D-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Dual Access (HMO-POS D-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Simple (HMO-POS)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Giveback Open (PPO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Assist Open (PPO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Dual Liberty Open (PPO D-SNP)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Wellcare Simple Open (PPO)
via Prolensa 		Tier 3 - Preferred Brand — — — None
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health Platinum (HMO)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health NC Duals (HMO-POS D-SNP)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health smartHMO (HMO)
via bromfenac 		Tier 3 - Preferred Brand — — — None
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via bromfenac 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Blue Medicare Essential (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Experience Health Medicare Advantage (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Simple (HMO-POS)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Dual Access (HMO-POS D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Dual Reserve (HMO-POS D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Dual Liberty (HMO-POS D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Extra (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Giveback (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring True Choice (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Healthy Blue + Medicare (HMO-POS D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring TotalCare (HMO D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Blue Medicare Choice (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring TotalCare Plus (HMO D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring Preferred Select (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring Preferred Savings (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthSpring Preferred Plus (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthTeam Advantage Plan I (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — ✓ 12 per 365 days QL
HealthTeam Advantage Plan II (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — ✓ 12 per 365 days QL
HealthTeam Advantage Vitality Plan (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — ✓ 12 per 365 days QL
Aetna Medicare Chronic Care Value (HMO C-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Chronic Care (HMO C-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Full Dual Care (HMO D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Care (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Prime (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Value Plus (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Dual (HMO D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — ✓ 12 per 365 days QL
Wellcare Giveback Open (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Assist Open (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Dual Liberty Open (PPO D-SNP)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Wellcare Simple Open (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Blue Medicare PPO Enhanced (PPO)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Blue Medicare Essential Plus (HMO-POS)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Blue Medicare Enhanced (HMO-POS)
via bromfenac 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via bromfenac 		Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026
via Prolensa 		Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Prolensa 		Tier 2 - Non-Preferred Generic — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Prolensa 		Tier 2 - Non-Preferred Generic — — — None
NC State Health Plan - HDHP 2026
via Prolensa 		Tier 2 - Non-Preferred Generic — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered — — — None
NC State Health Plan - HDHP 2026 Not Covered — — — None
Source: CMS QHP JSON  ·  Checked: 4 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Simple Diabetes | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Gold Elite Saver Plus | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Simple Diabetes | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple Chronic Care CKM | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
AIAN Cost Share
via bromfenac 		Tier 2 - Generic — — — None
AIAN Cost Share | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Classic 4700
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple PCP Saver
via bromfenac 		Tier 2 - Generic — — — None
Gold Elite Saver Plus
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple Diabetes
via bromfenac 		Tier 2 - Generic — — — None
Bronze Classic Standard
via bromfenac 		Tier 2 - Generic — — — None
Silver Classic Standard
via bromfenac 		Tier 2 - Generic — — — None
Gold Classic Standard
via bromfenac 		Tier 2 - Generic — — — None
Bronze Classic Standard | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Classic Standard | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Gold Classic Standard | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Simple Chronic Care CKM | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Secure | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Classic 4700 | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Classic | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Simple PCP Saver | with Atrium Health
via bromfenac 		Tier 2 - Generic — — — None
Silver Classic
via bromfenac 		Tier 2 - Generic — — — None
Bronze Elite + PCP Saver Plus
via bromfenac 		Tier 2 - Generic — — — None
Secure
via bromfenac 		Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Sep 23, 2026  ·  Checked: 4 hours, 32 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via bromfenac 		Tier 3 - Preferred Brand — — ✓ QL
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