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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.
Medicare Part D
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Alignment Health Platinum (HMO)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health smartHMO (HMO)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health Platinum Select (HMO)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |
|
Alignment Health AVA (PPO)
via dalbavancin |
Tier 5 - Specialty | — | — | — | None |