etoposide

Generic: Etopophos

50 MG — Capsule

Also known as: etoposide oral etoposide caps 50mg etoposide soln 1gm/50ml, 100mg/5ml, 500mg/25ml Etoposide 50 Mg Capsule etoposide caps 50mg; soln 100mg/5ml, 500mg/25ml etoposide soln 1gm/50ml, 100mg/5ml, etoposide caps 50mg; soln 1gm/50ml, 100mg/5ml, 500mg/25ml

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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)

58 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Focused Silver with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Complete Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Complete Gold + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Expanded Bronze + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Silver + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Gold + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Silver with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Gold with Atrium Health + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Complete Gold via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Clear Silver with $0 Insulin Options via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Expanded Bronze via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Silver via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Gold via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Expanded Bronze with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Silver with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Standard Gold with Atrium Health via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via Etopophos	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Clear Silver with $0 Insulin Options	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold	Tier 5 - Specialty	✓	—	✓	PA \| QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Focused Silver with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL

Blue Cross Blue Shield Federal

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Focus 2026	Tier 2 - Preferred Brand	—	—	—	None
BCBS Federal Standard Option 2026	Tier 4 - Preferred Specialty	—	—	—	None
BCBS Federal Basic Option 2026	Tier 4 - Preferred Specialty	—	—	—	None

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Local 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Care 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	—	—	—	None

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 4 - Specialty	—	—	— Specialty Pharmacy Required	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026	Tier 1 - Preferred Generic	—	—	—	None

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 6 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Unknown	—	—	—	None