cladribine
Generic: Mavenclad
10 mg, 10 mg, 10 mg, 10 mg, 10 mg, 10 mg, 10 mg — Tablet
ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS
Also known as:
cladribine soln 10mg/10ml
Mavenclad
cladribine tab therapy pack 10 mg (4 tabs), 10 mg (5 tabs), 10 mg (6 tabs), 10 mg (7 tabs), 10 mg (8 tabs), 10 mg (9 tabs), 10 mg (10 tabs)
Cladribine (10 Tabs) Oral Tablet Therapy Pack
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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.
AmeriHealth Caritas NC
19 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 5 - Specialty | — | — | — | None |
| Silver Classic | Tier 5 - Specialty | — | — | — | None |
| Secure | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic 4700 | Tier 5 - Specialty | — | — | — | None |
| Silver Simple PCP Saver | Tier 5 - Specialty | — | — | — | None |
| Gold Elite Saver Plus | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Diabetes | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Silver Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Gold Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Secure | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| AIAN Cost Share | Tier 5 - Specialty | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 5 - Specialty | — | — | — | None |