Fluad 2024-2025
Generic: influenza A virus A/Thailand/8/2022 (H3N2) antigen
0.015 MG — Prefilled Syringe
Also known as:
influenza A virus A/Thailand/8/2022 (H3N2) antigen
Fluad Intramuscular Suspension Prefilled Syringe
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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)
116 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Elite Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Flulaval 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Complete Gold | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Everyday Bronze | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Elite Bronze | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Expanded Bronze | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Silver | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Gold | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Focused Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Complete Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Complete Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Elite Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Silver + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Silver with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Standard Gold with Atrium Health
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health
via Afluria 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze + Vision + Adult Dental
via Fluarix 2024-2025 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
AmeriHealth Caritas NC
40 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Fluarix 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Flulaval 2024-2025 |
Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Afluria 2024-2025 |
Brand-Preferred | — | — | — | None |
Cigna
80 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Bronze 6500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Gold CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via Afluria 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Fluarix 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Flulaval 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 3500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |