clomiphene citrate

Generic: Clomid

50 MG — Tablet

Also known as: clomiphene citrate oral clomiphene citrate tabs 50mg clomiphene citrate tab 50 mg

Coverage by Insurer

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

Ambetter (Centene)

58 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 6 hours, 21 minutes ago

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

Blue Cross Blue Shield Federal

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 6 hours, 21 minutes ago

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

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 6 hours, 21 minutes ago

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

NC State Health Plan

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 6 hours, 21 minutes ago

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

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 6 hours, 21 minutes ago

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