Differin

Generic: adapalene

0.001 MG — Gel

Retinoid

Also known as: adapalene
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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: 17 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Gold with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Silver with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Gold + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Silver + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Expanded Bronze + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Complete Gold with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Focused Silver with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Elite Bronze with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Everyday Bronze with Atrium Health + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Elite Bronze + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Everyday Bronze + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Complete Gold + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Gold with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Silver with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Expanded Bronze with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Complete Gold with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Focused Silver with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Elite Bronze with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Everyday Bronze with Atrium Health
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Gold
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Silver
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Expanded Bronze
via adapalene 		Tier 2 - Generic — ✓ — ST
Clear Silver with $0 Insulin Options
via adapalene 		Tier 2 - Generic — ✓ — ST
Elite Bronze
via adapalene 		Tier 2 - Generic — ✓ — ST
Everyday Bronze
via adapalene 		Tier 2 - Generic — ✓ — ST
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via adapalene 		Tier 2 - Generic — ✓ — ST
Standard Silver with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Standard Gold with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Complete Gold + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Everyday Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Elite Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Focused Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Complete Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Expanded Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Silver + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Gold + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Standard Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — ✓ — ST
Complete Gold Tier 3 - Preferred Brand — ✓ — ST
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 3 - Preferred Brand — ✓ — ST
Everyday Bronze Tier 3 - Preferred Brand — ✓ — ST
Elite Bronze Tier 3 - Preferred Brand — ✓ — ST
Clear Silver with $0 Insulin Options Tier 3 - Preferred Brand — ✓ — ST
Standard Expanded Bronze Tier 3 - Preferred Brand — ✓ — ST
Standard Silver Tier 3 - Preferred Brand — ✓ — ST
Standard Gold Tier 3 - Preferred Brand — ✓ — ST
Everyday Bronze with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Elite Bronze with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Focused Silver with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Complete Gold with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Standard Expanded Bronze with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 17 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via adapalene 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via adapalene 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Community Plan (HMO I-SNP)
via adapalene 		Tier 1 - Preferred Generic — — — None
AmeriHealth Caritas VIP Care (HMO D-SNP)
via adapalene 		Tier 2 - Generic — — — None
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via adapalene 		Tier 2 - Generic — — — None
Troy Medicare (HMO)
via adapalene 		Tier 2 - Generic — — — None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
Humana Gold Plus H6622-061 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Choice H8145-004 (PFFS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0019 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0017 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0016 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0004 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0001 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S2 (PPO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S001 (PPO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
Humana Gold Plus H1036-137 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H1036-233 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Dual Select H1036-307 (HMO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H1036-335 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice Giveback H5216-017 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice H5216-211 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Full Access H5525-034 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice Giveback H5525-035 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice H5525-049 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice H5525-050 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice H5525-070 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Dual Select H5525-072 (PPO D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
HumanaChoice H5525-083 (PPO)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H6622-025 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H6622-026 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H6622-057 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
Humana Gold Plus H6622-060 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — ✓ 45 per 30 days QL
UHC Complete Care NC-25 (HMO-POS C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-27 (HMO-POS C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-28 (HMO-POS C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Champion (HMO-POS C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Guardian (HMO-POS I-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Plan I (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Plan II (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Vitality Plan (PPO)
via adapalene 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via adapalene 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Liberty (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Freedom (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Signature (HMO-POS)
via adapalene 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare Plus (HMO D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring Preferred Select (HMO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring Preferred Savings (HMO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Wellcare Dual Liberty Open (PPO D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Wellcare Assist Open (PPO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Wellcare Dual Access (HMO-POS D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Wellcare Dual Liberty (HMO-POS D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring Preferred (HMO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring Preferred Plus (HMO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Wellcare Dual Reserve (HMO-POS D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring True Choice (PPO)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
HealthSpring TotalCare (HMO D-SNP)
via adapalene 		Tier 4 - Non-Preferred — — ✓ 45 per 30 days QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via adapalene 		Preferred — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via adapalene 		Tier 3 - Non-Preferred Brand ✓ — — PA
NC State Health Plan - 70/30 Standard PPO 2026
via adapalene 		Tier 3 - Non-Preferred Brand ✓ — — PA
NC State Health Plan - HDHP 2026
via adapalene 		Tier 3 - Non-Preferred Brand ✓ — — PA
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 17 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via adapalene 		Tier 3 - Non-Formulary ✓ — — PA
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