Evekeo
Generic: amphetamine sulfate
5MG, 10MG — Tablet
Central Nervous System Stimulant
Also known as:
EVEKEO TABS 5MG, 10MG
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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)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Focused Silver with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Expanded Bronze
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Silver
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Gold
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
Complete Gold
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via amphetamine sulfate |
Tier 2 - Generic | — | ✓ | ✓ | ST | QL |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Gold CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect myDiabetesCare Silver
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver RD 2200 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Gold 1500 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect myDiabetesCare Bronze
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze 5500 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze RD 6000 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver 3500 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze RD 5000 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver RD 3500 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver 4400 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver RD 5000 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver 3000 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze 6500 Indiv Med Deductible
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Silver RD CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze RD CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Gold RD CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
|
Connect Bronze CMS Standard
via amphetamine sulfate |
Tier 3 - Preferred Brand | — | — | ✓ | QL |
NC Medicaid PDL
1 planNC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via amphetamine sulfate |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via amphetamine sulfate |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via amphetamine sulfate |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Bronze Simple Chronic Care CKM | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Chronic Care CKM | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Gold Elite Saver Plus | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700 | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Secure | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Gold Elite Saver Plus
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Secure
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
AIAN Cost Share | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
AIAN Cost Share
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via amphetamine sulfate |
Tier 2 - Generic | — | — | — | None |
UnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UHC Bronze Standard+ Dental + Vision (No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Silver Standard (No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Gold Standard (No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
UHC Bronze Standard (No Referrals)
via amphetamine sulfate |
Tier 4 - Non-Preferred | ✓ | — | — | PA |