crisaborole

Generic: Eucrisa

2 % — Ointment

ATOPY

Also known as: EUCRISA
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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.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 9 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Focused Silver with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Gold with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Gold + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Silver + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Expanded Bronze + Vision + Adult Dental
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Expanded Bronze
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Silver
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Gold
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Focused Silver with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Standard Silver with Atrium Health
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 9 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — — PA
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — — PA
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — — PA
NHC Advantage (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — ✓ 100 per 30 days PA | QL
Longevity Health Plan (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — ✓ 120 per 30 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — ✓ 100 per 30 days PA | QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — ✓ 100 per 30 days PA | QL
PruittHealth Premier (HMO I-SNP)
via Eucrisa 		Tier 1 - Preferred Generic ✓ — ✓ 100 per 30 days PA | QL
Senior Care (HMO I-SNP)
via Eucrisa 		Tier 3 - Preferred Brand ✓ — ✓ 100 per 30 days PA | QL
Liberty Medicare Advantage (HMO C-SNP)
via Eucrisa 		Tier 3 - Preferred Brand ✓ — ✓ 100 per 30 days PA | QL
Aetna Medicare Signature (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature Extra (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Enhanced (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Chronic Care (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Enhanced (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED DUAL 009 NC (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CORE 001 NC (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED GIVEBACK 002 NC (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED GIVEBACK 012 NC (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE 001 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE 003 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE 005 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE 008 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Enhanced (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Full Dual Care (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature Care (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature Giveback (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Simple Open (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Simple (HMO-POS)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Giveback Open (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare PPO Enhanced (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Essential Plus (HMO-POS)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Enhanced (HMO-POS)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Choice (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Essential (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Experience Health Medicare Advantage (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Healthy Blue + Medicare (HMO-POS D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health Platinum (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health NC Duals (HMO-POS D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health smartHMO (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health Platinum Select (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Alignment Health AVA (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
HealthTeam Advantage Plan I (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
HealthTeam Advantage Plan II (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
HealthTeam Advantage Vitality Plan (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Aetna Medicare Prime (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Value Plus (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Troy Medicare (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — — PA
Wellcare Dual Liberty Open (PPO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Assist Open (PPO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Dual Access (HMO-POS D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Dual Liberty (HMO-POS D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Wellcare Dual Reserve (HMO-POS D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Dual (HMO D-SNP)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (HMO)
via Eucrisa 		Tier 4 - Non-Preferred ✓ — ✓ 120 per 30 days PA | QL
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 9 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
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