Factive

Generic: gemifloxacin

320 MG — Tablet

Also known as: gemifloxacin

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  ·  Checked: 6 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Bronze Elite + PCP Saver Plus Tier 4 - Non-Preferred None
Silver Classic Tier 4 - Non-Preferred None
Secure Tier 4 - Non-Preferred None
Bronze Classic 4700 Tier 4 - Non-Preferred None
Silver Simple PCP Saver Tier 4 - Non-Preferred None
Gold Elite Saver Plus Tier 4 - Non-Preferred None
Silver Simple Diabetes Tier 4 - Non-Preferred None
Bronze Classic Standard Tier 4 - Non-Preferred None
Silver Classic Standard Tier 4 - Non-Preferred None
Gold Classic Standard Tier 4 - Non-Preferred None
Bronze Classic Standard | with Atrium Health Tier 4 - Non-Preferred None
Silver Classic Standard | with Atrium Health Tier 4 - Non-Preferred None
Gold Classic Standard | with Atrium Health Tier 4 - Non-Preferred None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred None
Bronze Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred None
Secure | with Atrium Health Tier 4 - Non-Preferred None
Bronze Classic 4700 | with Atrium Health Tier 4 - Non-Preferred None
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 4 - Non-Preferred None
Silver Classic | with Atrium Health Tier 4 - Non-Preferred None
Silver Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred None
Silver Simple PCP Saver | with Atrium Health Tier 4 - Non-Preferred None
Gold Elite Saver Plus | with Atrium Health Tier 4 - Non-Preferred None
Bronze Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred None
Silver Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 4 - Non-Preferred None
AIAN Cost Share Tier 4 - Non-Preferred None
AIAN Cost Share | with Atrium Health Tier 4 - Non-Preferred None
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