deflazacort
Generic: Jaythari
22.75mg — Tablet
Also known as:
Emflaza
deflazacort susp 22.75mg/ml; tabs 6mg, 18mg, 30mg, 36mg
deflazacort susp 22.75mg/ml; tabs 6mg, 18mg,
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
87 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold | Tier 5 - Specialty | ✓ | — | — | PA |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Clear Silver with $0 Insulin Options | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Expanded Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Expanded Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Silver | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Gold | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Silver with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Gold with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Silver + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Gold + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Focused Silver with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
12 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Focus 2026
via Jaythari |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Focus 2026
via Kymbee |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Focus 2026
via pyquvi |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
| BCBS Federal Basic Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Jaythari |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
| BCBS Federal Standard Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via pyquvi |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Kymbee |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Jaythari |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Kymbee |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via pyquvi |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Medicare Part D
85 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Erickson Advantage Liberty (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Signature (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Freedom (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Signature (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Freedom (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Erickson Advantage Liberty (HMO-POS)
via Kymbee |
Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Erickson Advantage Signature (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Erickson Advantage Freedom (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Erickson Advantage Liberty (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Jaythari |
Tier 5 - Specialty | ✓ | — | — | PA |
NC Medicaid PDL
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC Medicaid Preferred Drug List 2026 | Non-Preferred | ✓ | — | — | PA |
|
NC Medicaid Preferred Drug List 2026
via Jaythari |
Non-Preferred | — | — | — | None |
|
NC Medicaid Preferred Drug List 2026
via pyquvi |
Non-Preferred | — | — | — | None |
NC State Health Plan
12 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Jaythari |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Kymbee |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Kymbee |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - HDHP 2026
via Kymbee |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
| NC State Health Plan - HDHP 2026 | Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via pyquvi |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - HDHP 2026
via pyquvi |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 4 - Specialty Generic | ✓ | — | — | PA |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via pyquvi |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Jaythari |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Jaythari |
Tier 4 - Specialty Generic | ✓ | — | — | PA |