bupropion hcl tb24

Generic: bupropion hcl

450mg

0.9%

Also known as: bupropion hcl tb24 450mg

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via bupropion hcl
Tier 1 - Generic None
BCBS Federal Focus 2026
via bupropion hcl
Tier 1 - Generic None
BCBS Federal Basic Option 2026
via bupropion hcl
Tier 1 - Generic None
BCBS Federal Basic Option 2026
via Wellbutrin SR
Tier 3 - Non-Preferred Brand None
BCBS Federal Standard Option 2026
via Wellbutrin SR
Tier 3 - Non-Preferred Brand None
BCBS Federal Standard Option 2026
via Wellbutrin Xl
Tier 3 - Non-Preferred Brand None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026
via Wellbutrin SR
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Wellbutrin Xl
Tier 1 - Lowest Cost Generic None
BCBSNC Blue Local 2026
via Wellbutrin Xl
Tier 1 - Lowest Cost Generic None
BCBSNC Blue Care 2026
via Wellbutrin Xl
Tier 1 - Lowest Cost Generic None
BCBSNC Blue Value 2026
via Wellbutrin Xl
Tier 1 - Lowest Cost Generic None
BCBSNC Blue Advantage 2026
via bupropion hcl
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Home with UNC Health Alliance 2026
via bupropion hcl
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Local 2026
via bupropion hcl
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Care 2026
via bupropion hcl
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Value 2026
via bupropion hcl
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Local 2026
via Wellbutrin SR
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Wellbutrin SR
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Care 2026
via Wellbutrin SR
Tier 1 - Lowest Cost Generic QL
BCBSNC Blue Advantage 2026
via Wellbutrin Xl
Tier 1 - Lowest Cost Generic None
BCBSNC Blue Advantage 2026
via Wellbutrin SR
Tier 1 - Lowest Cost Generic QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via Bupropion Xl
Tier 1 - Generic QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Bupropion Xl
Non-Preferred None
NC Medicaid Preferred Drug List 2026
via Forfivo XL
Non-Preferred None
NC Medicaid Preferred Drug List 2026
via Wellbutrin SR
Non-Preferred None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via bupropion hcl
Tier 1 - Preferred Generic None
NC State Health Plan - HDHP 2026
via bupropion hcl
Tier 1 - Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026
via bupropion hcl
Tier 1 - Preferred Generic None
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
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via bupropion hcl
Tier 1 - Basic Core Formulary PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 22 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
via bupropion hcl
Tier 2 - Lower Cost None
Something not right?