diflorasone diacetate

0.0005 MG — Cream

CORTICOSTEROIDS-IMMUNE MODULATORS

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: 1 hour, 46 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Complete Gold with Atrium Health Tier 2 - Generic PA
Standard Expanded Bronze with Atrium Health Tier 2 - Generic PA
Standard Silver with Atrium Health Tier 2 - Generic PA
Standard Gold with Atrium Health Tier 2 - Generic PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 2 - Generic PA
Complete Gold + Vision + Adult Dental Tier 2 - Generic PA
Everyday Bronze + Vision + Adult Dental Tier 2 - Generic PA
Elite Bronze + Vision + Adult Dental Tier 2 - Generic PA
Complete Gold Tier 2 - Generic PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 2 - Generic PA
Everyday Bronze Tier 2 - Generic PA
Elite Bronze Tier 2 - Generic PA
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Focused Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Complete Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Standard Expanded Bronze + Vision + Adult Dental Tier 2 - Generic PA
Standard Silver + Vision + Adult Dental Tier 2 - Generic PA
Standard Gold + Vision + Adult Dental Tier 2 - Generic PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Standard Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Standard Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic PA
Clear Silver with $0 Insulin Options Tier 2 - Generic PA
Standard Expanded Bronze Tier 2 - Generic PA
Standard Silver Tier 2 - Generic PA
Standard Gold Tier 2 - Generic PA
Everyday Bronze with Atrium Health Tier 2 - Generic PA
Elite Bronze with Atrium Health Tier 2 - Generic PA
Focused Silver with Atrium Health Tier 2 - Generic PA
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 1 hour, 46 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Alignment Health Platinum (HMO) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health smartHMO (HMO) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health Platinum Select (HMO) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 4 - Non-Preferred 120 per 30 days QL
Alignment Health AVA (PPO) Tier 4 - Non-Preferred 120 per 30 days QL
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 1 hour, 46 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary PA
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