fenofibrate micronized

43mg, 67mg, 130mg, 134mg, 200mg — Capsule

CARDIOVASCULAR AGENTS - MISC.

Also known as: fenofibrate micronized oral capsule fenofibrate micronized caps 30mg, 90mg, 130mg fenofibrate micronized caps 43mg, 67mg, 134mg, 200mg fenofibrate micronized cap 67 mg, 134 mg, 200 mg fenofibrate micronized caps 43mg, 67mg, 130mg, 134mg, 200mg fenofibrate micronized caps 43mg, 67mg, fenofibrate micronized caps 130mg Fenofibrate Micronized Oral Capsule
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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.
Source: CMS QHP JSON  ·  Checked: 10 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 10 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 1 - Generic — — — None
BCBS Federal Basic Option 2026 Tier 1 - Generic — — — None
BCBS Federal Focus 2026 Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 10 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Advantage 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Local 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Care 2026 Tier 1 - Lowest Cost Generic — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 10 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 1 - Preferred Generic — — — None
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 1 - Preferred Generic — — — None
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 1 - Preferred Generic — — — None
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 1 - Preferred Generic — — — None
Erickson Advantage Champion (HMO-POS C-SNP) Tier 1 - Preferred Generic — — — None
Senior Care (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Liberty Medicare Advantage (HMO C-SNP) Tier 1 - Preferred Generic — — — None
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic — — — None
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic — — — None
Aetna Medicare Chronic Care (HMO C-SNP) Tier 1 - Preferred Generic — — — None
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 2 - Generic — — — None
Aetna Medicare Enhanced (HMO) Tier 2 - Generic — — — None
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 2 - Generic — — — None
Aetna Medicare Enhanced (PPO) Tier 2 - Generic — — — None
Aetna Medicare Enhanced (PPO) Tier 2 - Generic — — — None
Aetna Medicare Signature Extra (PPO) Tier 2 - Generic — — — None
Aetna Medicare Signature (PPO) Tier 2 - Generic — — — None
Aetna Medicare Signature (PPO) Tier 2 - Generic — — — None
Aetna Medicare Signature Giveback (PPO) Tier 2 - Generic — — — None
Aetna Medicare Signature (PPO) Tier 2 - Generic — — — None
HealthSpring True Choice (PPO) Tier 2 - Generic — — — None
HealthSpring Preferred (HMO) Tier 2 - Generic — — — None
HealthSpring Preferred Select (HMO) Tier 2 - Generic — — — None
HealthSpring Preferred Savings (HMO) Tier 2 - Generic — — — None
HealthSpring Preferred Plus (HMO) Tier 2 - Generic — — — None
Aetna Medicare Signature (PPO) Tier 2 - Generic — — — None
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 2 - Generic — — — None
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 2 - Generic — — — None
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 2 - Generic — — — None
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 2 - Generic — — — None
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 2 - Generic — — — None
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 2 - Generic — — — None
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 2 - Generic — — — None
Erickson Advantage Signature (HMO-POS) Tier 2 - Generic — — — None
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 2 - Generic — — — None
Erickson Advantage Freedom (HMO-POS) Tier 2 - Generic — — — None
Erickson Advantage Liberty (HMO-POS) Tier 2 - Generic — — — None
Aetna Medicare Signature (HMO) Tier 2 - Generic — — — None
Aetna Medicare Dual (HMO D-SNP) Tier 2 - Generic — — — None
Aetna Medicare Signature (HMO) Tier 2 - Generic — — — None
Aetna Medicare Value Plus (HMO) Tier 2 - Generic — — — None
Aetna Medicare Prime (HMO) Tier 2 - Generic — — — None
Aetna Medicare Signature Care (HMO) Tier 2 - Generic — — — None
Wellcare Simple Open (PPO) Tier 2 - Generic — — — None
Wellcare Simple (HMO-POS) Tier 2 - Generic — — — None
Wellcare Giveback Open (PPO) Tier 2 - Generic — — — None
Blue Medicare PPO Enhanced (PPO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Blue Medicare Essential Plus (HMO-POS) Tier 2 - Generic — — ✓ 30 per 30 days QL
Blue Medicare Enhanced (HMO-POS) Tier 2 - Generic — — ✓ 30 per 30 days QL
Blue Medicare Choice (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Blue Medicare Essential (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Experience Health Medicare Advantage (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health Platinum (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health smartHMO (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health Platinum Select (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Alignment Health AVA (PPO) Tier 2 - Generic — — ✓ 30 per 30 days QL
HealthTeam Advantage Plan I (PPO) Tier 2 - Generic — — — None
HealthTeam Advantage Plan II (PPO) Tier 2 - Generic — — — None
HealthTeam Advantage Vitality Plan (PPO) Tier 2 - Generic — — — None
Troy Medicare (HMO) Tier 2 - Generic — — — None
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 2 - Generic — — — None
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 2 - Generic — — — None
Wellcare Dual Liberty Open (PPO D-SNP) Tier 2 - Generic — — — None
Wellcare Assist Open (PPO) Tier 2 - Generic — — — None
Wellcare Dual Access (HMO-POS D-SNP) Tier 2 - Generic — — — None
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 2 - Generic — — — None
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 2 - Generic — — — None
HumanaChoice H5525-083 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare Plus (HMO D-SNP) Tier 3 - Preferred Brand — — — None
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
DEVOTED CORE 001 NC (HMO) Tier 3 - Preferred Brand — — — None
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare (HMO D-SNP) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 001 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED GIVEBACK 012 NC (HMO) Tier 3 - Preferred Brand — — — None
DEVOTED GIVEBACK 002 NC (HMO) Tier 3 - Preferred Brand — — — None
Humana Gold Plus H1036-137 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice Giveback H5216-017 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
DEVOTED CHOICE 008 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 009 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 005 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 003 NC (PPO) Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 3 - Preferred Brand — — — None
HumanaChoice H5216-211 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Full Access H5525-034 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice Giveback H5525-035 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice H5525-049 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice H5525-050 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HumanaChoice H5525-070 (PPO) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) Tier 3 - Preferred Brand — — — None
Humana Gold Plus H6622-025 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
Humana Gold Choice H8145-004 (PFFS) Tier 3 - Preferred Brand — — ✓ 30 per 30 days QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 6 - Specialty Plus — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 10 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered — — — None
NC State Health Plan - HDHP 2026 Not Covered — — — None
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