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 |
|---|---|---|---|---|---|
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Complete Gold
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Everyday Bronze
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Elite Bronze
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Expanded Bronze
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Silver
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Gold
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via difluprednate |
Tier 2 - Generic | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
Medicare Part D
61 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Liberty Medicare Dual Plan (HMO D-SNP)
via difluprednate |
Tier 1 - Preferred Generic | — | — | — | None |
|
NHC Advantage (HMO I-SNP)
via difluprednate |
Tier 1 - Preferred Generic | — | — | — | None |
|
PruittHealth Premier (HMO I-SNP)
via difluprednate |
Tier 1 - Preferred Generic | — | — | — | None |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via difluprednate |
Tier 1 - Preferred Generic | — | — | — | None |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via difluprednate |
Tier 2 - Generic | — | — | — | None |
|
Senior Care (HMO I-SNP)
via difluprednate |
Tier 2 - Generic | — | — | — | None |
|
Liberty Medicare Advantage (HMO C-SNP)
via difluprednate |
Tier 2 - Generic | — | — | — | None |
|
Troy Medicare (HMO)
via difluprednate |
Tier 2 - Generic | — | — | — | None |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via difluprednate |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring Preferred Plus (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health smartHMO (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health Platinum (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health Platinum Select (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health AVA (PPO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring True Choice (PPO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring TotalCare (HMO D-SNP)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred Select (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred Savings (HMO)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via difluprednate |
Tier 3 - Preferred Brand | — | — | — | None |
|
Blue Medicare Choice (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Dual (HMO D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Value Plus (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Prime (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Care (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Extra (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature Giveback (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CORE 001 NC (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED GIVEBACK 002 NC (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED GIVEBACK 012 NC (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Simple Open (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Simple (HMO-POS)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Giveback Open (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Blue Medicare PPO Enhanced (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Blue Medicare Essential Plus (HMO-POS)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Blue Medicare Enhanced (HMO-POS)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Blue Medicare Essential (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Experience Health Medicare Advantage (HMO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Liberty Open (PPO D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Assist Open (PPO)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Access (HMO-POS D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Liberty (HMO-POS D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via difluprednate |
Tier 4 - Non-Preferred | — | — | — | None |