Fentora

Generic: fentanyl citrate

100 MCG, 200 MCG, 400 MCG, 600 MCG, 800 MCG — TABLET EFF

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

7 plans

Source: CMS QHP JSON · Formulary date: Sep 22, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Premier + No Referrals via fentanyl citrate buccal	Tier 5 - Specialty	✓	—	—	PA

3 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via fentanyl citrate	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via fentanyl citrate	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via fentanyl citrate	Not Covered	—	—	—	None

2 plans

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 5 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via fentanyl citrate	Tier 3 - Non-Formulary	—	—	—	None
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None