Emverm

Generic: mebendazole

100 MG — Chewable Tablet

Anthelmintic

Also known as: mebendazole Emverm 100 Mg Chewable Tablet Emverm Oral Tablet Chewable Mebendazole
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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: 21 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold Tier 3 - Preferred Brand — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze Tier 3 - Preferred Brand — — ✓ QL
Clear Silver with $0 Insulin Options Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze Tier 3 - Preferred Brand — — ✓ QL
Standard Silver Tier 3 - Preferred Brand — — ✓ QL
Standard Gold Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Focused Silver with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Complete Gold with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Silver with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Gold with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Complete Gold + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Silver + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Gold + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Source: CMS QHP JSON  ·  Checked: 21 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 21 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver 3000 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect myDiabetesCare Silver Tier 4 - Non-Preferred — — — None
Connect Silver RD 2200 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Gold 1500 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect myDiabetesCare Bronze Tier 4 - Non-Preferred — — — None
Connect Bronze 5500 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Bronze RD 6000 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Silver 3500 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Bronze RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Silver RD 3500 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Silver 4400 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Silver RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Bronze 6500 Indiv Med Deductible Tier 4 - Non-Preferred — — — None
Connect Silver CMS Standard Tier 4 - Non-Preferred — — — None
Connect Silver RD CMS Standard Tier 4 - Non-Preferred — — — None
Connect Gold CMS Standard Tier 4 - Non-Preferred — — — None
Connect Bronze RD CMS Standard Tier 4 - Non-Preferred — — — None
Connect Gold RD CMS Standard Tier 4 - Non-Preferred — — — None
Connect Bronze CMS Standard Tier 4 - Non-Preferred — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 21 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Aetna Medicare Signature Care (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Prime (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Value Plus (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Dual (HMO D-SNP) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature Extra (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature Giveback (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 5 - Specialty — — ✓ 24 per 365 days QL
HealthSpring True Choice (PPO) Tier 5 - Specialty — — — None
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty — — — None
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty — — — None
HealthSpring Preferred (HMO) Tier 5 - Specialty — — — None
HealthSpring Preferred Select (HMO) Tier 5 - Specialty — — — None
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty — — — None
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty — — — None
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CORE 001 NC (HMO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED GIVEBACK 002 NC (HMO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED GIVEBACK 012 NC (HMO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE 001 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE 003 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE 005 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE 008 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
DEVOTED CHOICE GIVEBACK 009 NC (PPO) Tier 5 - Specialty — — ✓ 12 per 365 days QL
Wellcare Simple Open (PPO) Tier 5 - Specialty — — — None
Wellcare Simple (HMO-POS) Tier 5 - Specialty — — — None
Wellcare Giveback Open (PPO) Tier 5 - Specialty — — — None
Wellcare Dual Liberty Open (PPO D-SNP) Tier 5 - Specialty — — — None
Wellcare Assist Open (PPO) Tier 5 - Specialty — — — None
Wellcare Dual Access (HMO-POS D-SNP) Tier 5 - Specialty — — — None
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 5 - Specialty — — — None
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 5 - Specialty — — — None
Aetna Medicare Enhanced (HMO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty — — ✓ 24 per 365 days QL
Source: CMS QHP JSON  ·  Checked: 21 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Secure | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple PCP Saver | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Elite Saver Plus | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
AIAN Cost Share Tier 4 - Non-Preferred ✓ — ✓ PA | QL
AIAN Cost Share | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic Standard Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Standard Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic Standard | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Standard | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Secure Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic 4700 Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple PCP Saver Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Elite Saver Plus Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Diabetes Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic 4700 | with Atrium Health Tier 4 - Non-Preferred ✓ — ✓ PA | QL
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