fingolimod hcl

0.5 mg — Capsule

Also known as: fingolimod hcl cap 0.5 mg (base equiv) fingolimod hcl caps .5mg

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

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 13 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Focus 2026	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Basic Option 2026	Tier 4 - Preferred Specialty	✓	—	—	PA
BCBS Federal Standard Option 2026	Tier 4 - Preferred Specialty	✓	—	—	PA

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 13 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026 via Gilenya	Tier 2 - Medium Cost Generic/Brand	✓	—	✓	PA \| QL
BCBSNC Blue Care 2026 via Gilenya	Tier 2 - Medium Cost Generic/Brand	✓	—	✓	PA \| QL
BCBSNC Blue Value 2026 via Gilenya	Tier 2 - Medium Cost Generic/Brand	✓	—	✓	PA \| QL
BCBSNC Blue Advantage 2026 via Gilenya	Tier 2 - Medium Cost Generic/Brand	✓	—	✓	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026 via Gilenya	Tier 2 - Medium Cost Generic/Brand	✓	—	✓	PA \| QL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 13 hours, 25 minutes ago

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

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 13 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 70/30 Standard PPO 2026	Tier 4 - Specialty Generic	✓	—	✓	PA \| QL
NC State Health Plan - 80/20 Plus PPO 2026	Tier 4 - Specialty Generic	✓	—	✓	PA \| QL
NC State Health Plan - HDHP 2026	Tier 4 - Specialty Generic	✓	—	✓	PA \| QL
NC State Health Plan - HDHP 2026 via Gilenya	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Gilenya	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Gilenya	Not Covered	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 13 hours, 25 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Unknown	✓	—	✓	PA \| QL