Calcidol

Generic: ergocalciferol

0.2 MG — Solution

Provitamin D2 Compound

Also known as: ergocalciferol
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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: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold
via ergocalciferol 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health
via ergocalciferol 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Expanded Bronze + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Silver + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Gold + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health + Vision + Adult Dental
via ergocalciferol 		Tier 2 - Generic — — — None
Everyday Bronze
via ergocalciferol 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Silver
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Gold
via ergocalciferol 		Tier 2 - Generic — — — None
Elite Bronze
via ergocalciferol 		Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options
via ergocalciferol 		Tier 2 - Generic — — — None
Standard Expanded Bronze
via ergocalciferol 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Gold with Atrium Health Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Expanded Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Silver + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Gold + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Complete Gold Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 2 - Generic — — — None
Everyday Bronze Tier 2 - Generic — — — None
Elite Bronze Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options Tier 2 - Generic — — — None
Standard Expanded Bronze Tier 2 - Generic — — — None
Standard Silver Tier 2 - Generic — — — None
Standard Gold Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health Tier 2 - Generic — — — None
Elite Bronze with Atrium Health Tier 2 - Generic — — — None
Focused Silver with Atrium Health Tier 2 - Generic — — — None
Complete Gold with Atrium Health Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health Tier 2 - Generic — — — None
Standard Silver with Atrium Health Tier 2 - Generic — — — None
Source: CMS QHP JSON  ·  Checked: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Premier + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Signature + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Signature + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Essential + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Essential + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Gold Signature + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Premier + No Referrals
via ergocalciferol 		Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026
via ergocalciferol 		Tier 1 - Generic — — — None
BCBS Federal Standard Option 2026
via ergocalciferol 		Tier 1 - Generic — — — None
BCBS Federal Focus 2026
via ergocalciferol 		Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026
via Drisdol 		Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Home with UNC Health Alliance 2026
via Drisdol 		Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Local 2026
via Drisdol 		Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Care 2026
via Drisdol 		Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Value 2026
via Drisdol 		Tier 1 - Lowest Cost Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
NC State Health Plan - HDHP 2026
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Drisdol 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - HDHP 2026
via Drisdol 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Drisdol 		Tier 3 - Non-Preferred Brand — — — None
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 19 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Bronze Standard+ Dental + Vision (No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Gold Standard (No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Silver Standard (No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Bronze Standard (No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via ergocalciferol 		Tier 1 - Preferred Generic — — — None
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