Clomid

Generic: clomiphene

50 MG — Tablet

Also known as: clomid tabs 50mg clomiphene citrate Clomid Tabs 50mg

Coverage by Insurer

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

Ambetter (Centene)

87 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Standard Expanded Bronze with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Clear Silver with $0 Insulin Options via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health + Vision + Adult Dental via clomiphene citrate	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze	Tier 4 - Non-Preferred	✓	—	—	PA
Clear Silver with $0 Insulin Options	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health + Vision + Adult Dental	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Silver with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Gold with Atrium Health via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Complete Gold via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Everyday Bronze via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Elite Bronze via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Clear Silver with $0 Insulin Options via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA
Standard Expanded Bronze via Milophene	Tier 4 - Non-Preferred	✓	—	—	PA

Blue Cross Blue Shield Federal

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Basic Option 2026	Tier 1 - Generic	✓	—	—	PA
BCBS Federal Basic Option 2026 via clomiphene citrate	Tier 1 - Generic	✓	—	—	PA
BCBS Federal Focus 2026	Tier 1 - Generic	✓	—	—	PA
BCBS Federal Focus 2026 via clomiphene citrate	Tier 1 - Generic	✓	—	—	PA
BCBS Federal Standard Option 2026	Tier 1 - Generic	✓	—	—	PA
BCBS Federal Standard Option 2026 via clomiphene citrate	Tier 1 - Generic	✓	—	—	PA

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via clomiphene citrate	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026 via clomiphene citrate	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Local 2026 via clomiphene citrate	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Care 2026 via clomiphene citrate	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Value 2026 via clomiphene citrate	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Clomiphene	Tier 1 - Generic	—	—	—	None

NC State Health Plan

9 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 70/30 Standard PPO 2026	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - HDHP 2026	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - 80/20 Plus PPO 2026 via clomiphene citrate	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - 70/30 Standard PPO 2026 via clomiphene citrate	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - 80/20 Plus PPO 2026	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - 80/20 Plus PPO 2026 via Milophene	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - 70/30 Standard PPO 2026 via Milophene	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - HDHP 2026 via Milophene	Tier 1 - Preferred Generic	✓	—	—	PA
NC State Health Plan - HDHP 2026 via clomiphene citrate	Tier 1 - Preferred Generic	✓	—	—	PA

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 21 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via clomiphene citrate	Tier 3 - Mid-Range Cost	✓	—	—	PA