Cortrophin
Generic: corticotropin
40 UNIT/0.5ML — Injection
Also known as:
corticotropin
CORTROPHIN GEL 80UNIT/ML
CORTROPHIN GEL 80UNIT/ML; PRSY 40UNIT/0.5ML, 80UNIT/ML
Cortrophin Injection Gel
Cortrophin Gel Subcutaneous Prefilled Syringe
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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.
Ambetter (Centene)
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Enhanced CHF Heart Care Silver $0 Rx Options
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Expanded Bronze
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Silver
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Gold
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Expanded Bronze with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Silver with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Gold with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Expanded Bronze + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Silver + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Gold + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Streamlined Silver
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Streamlined Silver with Atrium Health
via Acthar |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
AmeriHealth Caritas NC
22 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| 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 Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Acthar |
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 Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Acthar |
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
via Acthar |
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 Silver Off-Marketplace High + 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 Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
2 plansBlue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Value 2026
via Acthar |
Tier 5 - Specialty | ✓ | — | — Restricted Access; Limited Distribution | PA |
|
BCBSNC Blue Care 2026
via Acthar |
Tier 5 - Specialty | ✓ | — | — Restricted Access; Limited Distribution | PA |
|
BCBSNC Blue Local 2026
via Acthar |
Tier 5 - Specialty | ✓ | — | — Restricted Access; Limited Distribution | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Acthar |
Tier 5 - Specialty | ✓ | — | — Restricted Access; Limited Distribution | PA |
|
BCBSNC Blue Advantage 2026
via Acthar |
Tier 5 - Specialty | ✓ | — | — Restricted Access; Limited Distribution | PA |
Medicare Part D
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health smartHMO (HMO)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Platinum Select (HMO)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health AVA (PPO)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Platinum (HMO)
via Acthar |
Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Acthar |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Acthar |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via Acthar |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - HDHP 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |