dexlansoprazole
30 mg, 60 mg — Delayed Release Capsule
Also known as:
dexlansoprazole cap delayed release 30 mg, 60 mg
Dexlansoprazole Dr 30 Mg Capsule
Dexlansoprazole Dr 60 Mg Capsule
DEXILANT
DEXLANSOPRAZOLE DR
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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)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Focused Silver with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Value 2026
via Dexilant |
Tier 2 - Medium Cost Generic/Brand | — | — | — Restricted Access | None |
|
BCBSNC Blue Advantage 2026
via Dexilant |
Tier 2 - Medium Cost Generic/Brand | — | — | — Restricted Access | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Dexilant |
Tier 2 - Medium Cost Generic/Brand | — | — | — Restricted Access | None |
|
BCBSNC Blue Local 2026
via Dexilant |
Tier 2 - Medium Cost Generic/Brand | — | — | — Restricted Access | None |
|
BCBSNC Blue Care 2026
via Dexilant |
Tier 2 - Medium Cost Generic/Brand | — | — | — Restricted Access | None |
Cigna
1 planMedicare Part D
65 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Wellcare Giveback Open (PPO) | Tier 2 - Generic | — | — | ✓ 30 per 30 days | QL |
| Wellcare Simple (HMO-POS) | Tier 2 - Generic | — | — | ✓ 30 per 30 days | QL |
| Wellcare Simple Open (PPO) | Tier 2 - Generic | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature Care (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Enhanced (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature Giveback (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health Platinum (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health Platinum Select (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health AVA (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Assist Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Alignment Health smartHMO (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Erickson Advantage Signature (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Erickson Advantage Freedom (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Erickson Advantage Liberty (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Dual (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Value Plus (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Aetna Medicare Prime (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |