ciprofloxacin solution

Drops

Also known as: Ciloxan

Coverage by Insurer

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

Medicare Part D

37 plans

Source: CMS QHP JSON · Formulary date: Mar 18, 2026 · Checked: 9 hours, 7 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
DEVOTED CHOICE GIVEBACK 009 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE GIVEBACK 006 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE 008 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
Aetna Medicare Signature (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Dual (HMO D-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Value Plus (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Prime (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature Care (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Full Dual Care (HMO D-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Enhanced (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Enhanced (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Enhanced (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature Extra (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature Giveback (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Signature (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Chronic Care (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
Aetna Medicare Chronic Care Value (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	✓ 42 per 30 days	QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED DUAL 009 NC (HMO D-SNP) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CORE 001 NC (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED GIVEBACK 002 NC (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED GIVEBACK 012 NC (HMO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE 001 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE GIVEBACK 002 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE 003 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE GIVEBACK 004 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None
DEVOTED CHOICE 005 NC (PPO) via Ciloxan	Tier 3 - Preferred Brand	—	—	—	None

NC Medicaid PDL

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 9 hours, 7 minutes ago

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