Fiber Tab
Generic: calcium polycarbophil
625 MG — Tablet
Also known as:
calcium polycarbophil
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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)
102 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Complete Gold
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver with Atrium Health
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via FiberCon |
Tier 2 - Generic | — | — | — | None |
| Complete Gold | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver $0 Rx Options | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze | Tier 2 - Generic | — | — | — | None |
| Elite Bronze | Tier 2 - Generic | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | — | None |
| Signature Expanded Bronze | Tier 2 - Generic | — | — | — | None |
| Signature Silver | Tier 2 - Generic | — | — | — | None |
| Signature Gold | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Signature Expanded Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Signature Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Signature Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 2 - Generic | — | — | — | None |
| Streamlined Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Streamlined Silver | Tier 2 - Generic | — | — | — | None |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
|
Complete Gold
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver with Atrium Health
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via calcium polycarbophil |
Tier 2 - Generic | — | — | — | None |