Bupropion Xl
Generic: bupropion hcl
150 Mg — Tablet
Also known as:
Forfivo XL
Bupropion Xl 150 Mg Tablet
Bupropion Xl 300 Mg Tablet
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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.
Blue Cross Blue Shield Federal
6 plans| 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 |
Blue Cross Blue Shield of NC
15 plans| 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 |
Cigna
1 planNC Medicaid PDL
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC Medicaid Preferred Drug List 2026 | 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 |
NC State Health Plan
6 plans| 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
via bupropion hcl tb24 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via bupropion hcl tb24 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via bupropion hcl tb24 |
Not Covered | — | — | — | None |