Calcipotriene-Betamethasone

Generic: calcipotriene/betamethasone dipropionate

Ointment

Also known as: Calcipotriene-Betamethasone Ointment

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 20 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via Wynzora	Tier 3 - Non-Preferred Brand	✓	—	—	PA

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 20 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Taclonex	Non-Preferred	—	—	—	None

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 20 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Taclonex	Tier 3 - Non-Preferred Brand	✓	—	—	PA
NC State Health Plan - 70/30 Standard PPO 2026 via Taclonex	Tier 3 - Non-Preferred Brand	✓	—	—	PA
NC State Health Plan - HDHP 2026 via Taclonex	Tier 3 - Non-Preferred Brand	✓	—	—	PA

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 20 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via calcipotriene/betamethasone dipropionate	Tier 3 - Non-Formulary	✓	—	—	PA