disopyramide
Generic: Norpace
100 MG — Capsule
Also known as:
Norpace
Disopyramide 100 Mg Capsule
Disopyramide 150 Mg Capsule
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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 | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze | Tier 2 - Generic | — | — | — | None |
| Elite Bronze | Tier 2 - Generic | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze | Tier 2 - Generic | — | — | — | None |
| Standard Silver | Tier 2 - Generic | — | — | — | None |
| Standard Gold | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold | Tier 2 - Generic | — | — | — | None |
AmeriHealth Caritas NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Norpace |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Norpace |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Value 2026
via Norpace |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Care 2026
via Norpace |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Local 2026
via Norpace |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Silver CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver 3500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze CMS Standard | Tier 2 - Generic | — | — | — | None |
Medicare Part D
75 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Troy Medicare (HMO) | Tier 2 - Generic | — | — | — | None |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| Senior Care (HMO I-SNP) | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Extra (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CORE 001 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 001 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 003 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 005 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 008 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Simple Open (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Simple (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Giveback Open (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
|
Troy Medicare (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Assist Open (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Care (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Prime (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Value Plus (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Dual (HMO D-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (HMO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Giveback (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Dual (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Value Plus (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Prime (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature Care (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Enhanced (HMO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature Extra (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature Giveback (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Norpace |
Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | — | PA |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
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Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Norpace |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
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Not Covered | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Silver Classic | Tier 2 - Generic | — | — | — | None |
| Secure | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | Tier 2 - Generic | — | — | — | None |
| Gold Elite Saver Plus | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | Tier 2 - Generic | — | — | — | None |
| Secure | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| AIAN Cost Share | Tier 2 - Generic | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
UnitedHealthcare
26 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UHC Silver Standard (No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Bronze Standard (No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Gold Standard (No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Norpace |
Tier 3 - Preferred Brand | — | — | — | None |