Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Silver Simple PCP Saver | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Secure | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700 | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Gold Elite Saver Plus | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Chronic Care CKM | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Chronic Care CKM | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AIAN Cost Share
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
AIAN Cost Share | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard | with Atrium Health
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Secure
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Gold Elite Saver Plus
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes
via Erythrocin Stearate |
Tier 2 - Generic | — | — | — | None |
TRICARE
1 planUnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Bronze Standard (No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Silver Standard (No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |
|
UHC Gold Standard (No Referrals)
via Erythrocin Stearate |
Tier 4 - Non-Preferred | — | — | — | None |