Doral

Generic: Quazepam

Tablet

Sedative Hypnotics — Quantity limits apply to all sedative hypnotics

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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  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Essential + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Signature + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Premier + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Gold Signature + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Gold Premier + No Referrals
via Quazepam 		Tier 2 - Generic — — ✓ QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect myDiabetesCare Silver
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold 1500 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Bronze
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3500 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 4400 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3000 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold RD CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze CMS Standard
via Quazepam 		Tier 4 - Non-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026
via Quazepam 		Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Quazepam 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Quazepam 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Quazepam 		Not Covered — — — None
Source: CMS QHP JSON  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AIAN Cost Share
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic Standard
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Classic Standard
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Gold Classic Standard
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic Standard | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Classic Standard | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Gold Classic Standard | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Elite + PCP Saver Plus
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Classic
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Secure
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic 4700
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple PCP Saver
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Gold Elite Saver Plus
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Diabetes
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Secure | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic 4700 | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Elite + PCP Saver Plus | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Classic | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Diabetes | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple PCP Saver | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Gold Elite Saver Plus | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Chronic Care CKM | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Diabetes | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Chronic Care CKM | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
AIAN Cost Share | with Atrium Health
via Quazepam 		Tier 3 - Preferred Brand — ✓ — ST
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 11 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Bronze Standard (No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Gold Standard (No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
UHC Silver Standard (No Referrals)
via Quazepam 		Tier 4 - Non-Preferred — — — None
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