darifenacin hydrobromide tb24

Generic: darifenacin hydrobromide

7.5mg, 15mg

Cholinergic Muscarinic Antagonist

Also known as: darifenacin hydrobromide tb24 7.5mg, 15mg
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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  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Signature + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Essential + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Signature + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Signature + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Essential + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Premier + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Premier + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Premier + No Referrals
via darifenacin hydrobromide 		Tier 2 - Generic — ✓ — ST
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via darifenacin hydrobromide 		Tier 1 - Generic — — — None
BCBS Federal Focus 2026
via darifenacin hydrobromide 		Tier 1 - Generic — — — None
BCBS Federal Basic Option 2026
via darifenacin hydrobromide 		Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze 5500 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect myDiabetesCare Silver
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver RD 2200 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Gold 1500 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect myDiabetesCare Bronze
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver 3500 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver RD 3500 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver 4400 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver RD 5000 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver 3000 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze 6500 Indiv Med Deductible
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Silver RD CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Gold CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze RD CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Gold RD CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Connect Bronze CMS Standard
via DARIFENACIN ER 		Tier 2 - Generic — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via DARIFENACIN ER 		Tier 2 - Generic — ✓ — ST
Troy Medicare (HMO)
via DARIFENACIN ER 		Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas VIP Care (HMO D-SNP)
via DARIFENACIN ER 		Tier 2 - Generic — ✓ ✓ 30 per 30 days ST | QL
HealthSpring TotalCare Plus (HMO D-SNP)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
DEVOTED GIVEBACK 012 NC (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — ✓ ✓ 30 per 30 days ST | QL
HealthSpring Preferred Savings (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
DEVOTED CORE 001 NC (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — ✓ ✓ 30 per 30 days ST | QL
DEVOTED DUAL 009 NC (HMO D-SNP)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — ✓ ✓ 30 per 30 days ST | QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — ✓ ✓ 30 per 30 days ST | QL
HealthSpring Preferred Plus (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
HealthSpring Preferred Select (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
HealthSpring Preferred (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
DEVOTED GIVEBACK 002 NC (HMO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — ✓ ✓ 30 per 30 days ST | QL
HealthSpring TotalCare (HMO D-SNP)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
HealthSpring True Choice (PPO)
via DARIFENACIN ER 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026 Tier 1 - Preferred Generic — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 1 - Preferred Generic — — — None
NC State Health Plan - 80/20 Plus PPO 2026 Tier 1 - Preferred Generic — — — None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 14 hours, 48 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via darifenacin hydrobromide 		Tier 3 - Non-Formulary ✓ — — PA
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