famotidine tablet

Suspension

Also known as: Pepcid

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

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 14 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Complete Gold via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Everyday Bronze via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Elite Bronze via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Clear Silver with $0 Insulin Options via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Expanded Bronze via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Silver via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Gold via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Everyday Bronze with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Elite Bronze with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Focused Silver with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Complete Gold with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Expanded Bronze with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Silver with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Gold with Atrium Health via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Complete Gold + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Everyday Bronze + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Elite Bronze + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Everyday Bronze with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Elite Bronze with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Focused Silver with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Complete Gold with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Expanded Bronze + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Silver + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Gold + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Silver with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None
Standard Gold with Atrium Health + Vision + Adult Dental via Pepcid	Tier 4 - Non-Preferred	—	—	—	None

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Pepcid	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Pepcid	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Pepcid	Tier 3 - Non-Preferred Brand	—	—	—	None