CIPROFLOX-FLUOCINLN

0.025% — Solution

Also known as: Ciprofloxacin-Fluocinolone PF Otic Solution
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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, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 2 - Generic — ✓ — ST
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 5 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Gold RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Gold CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand ✓ — — PA
Connect myDiabetesCare Silver Tier 3 - Preferred Brand ✓ — — PA
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