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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.
TRICARE
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 1 - Generic Formulary | — | ✓ | — | ST Step therapy on 1 of 2 NDCs: CLINDAGEL,CLINDACIN ETZ/PAC,NEUAC,ONEXTON, WO 3 DIFF GEN ACNE DRUGS IN LAST 180D REQ PA |
|
TRICARE Uniform Formulary 2026
via Clindacin Pac |
Tier 3 - Non-Formulary | — | ✓ | — | ST Step therapy: CLINDAGEL,CLINDACIN ETZ/PAC,NEUAC,ONEXTON, WO 3 DIFF GEN ACNE DRUGS IN LAST 180D REQ PA |