BUDESONIDE-FORMOTEROL

4.5 MCG — Aerosol

Also known as: Budesonide-Formoterol Fumarate Inhalation Aerosol
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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  ·  Checked: 5 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + No Referrals Brand-Preferred — — ✓ QL
AmeriHealth Caritas Next Bronze Signature + No Referrals Brand-Preferred — — ✓ QL
AmeriHealth Caritas Next Silver Signature + No Referrals Brand-Preferred — — ✓ QL
AmeriHealth Caritas Next Gold Signature + No Referrals Brand-Preferred — — ✓ QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 5 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver 3000 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect Silver CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect Gold CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect myDiabetesCare Bronze Tier 4 - Non-Preferred — — ✓ QL
Connect myDiabetesCare Silver Tier 4 - Non-Preferred — — ✓ QL
Connect Gold 1500 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze 6500 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze RD CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect Silver RD 3500 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Silver RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Silver RD CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect Silver RD 2200 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Gold RD CMS Standard Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze 7000 HSA Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze RD 6000 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Bronze 5500 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Silver 4400 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
Connect Silver 3500 Indiv Med Deductible Tier 4 - Non-Preferred — — ✓ QL
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