clascoterone

1 % — Cream

Also known as: WINLEVI

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

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 16 hours, 48 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Winlevi	Tier 4 - Higher Cost Brand	✓	—	— Restricted Access	PA
BCBSNC Blue Home with UNC Health Alliance 2026 via Winlevi	Tier 4 - Higher Cost Brand	✓	—	— Restricted Access	PA
BCBSNC Blue Local 2026 via Winlevi	Tier 4 - Higher Cost Brand	✓	—	— Restricted Access	PA
BCBSNC Blue Care 2026 via Winlevi	Tier 4 - Higher Cost Brand	✓	—	— Restricted Access	PA
BCBSNC Blue Value 2026 via Winlevi	Tier 4 - Higher Cost Brand	✓	—	— Restricted Access	PA

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 16 hours, 47 minutes ago

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

1 plan

Source: Excel (XLSX) · Formulary date: Jul 31, 2026 · Checked: 16 hours, 47 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	✓	PA \| QL