Fluzone 2025-2026
Generic: influenza virus vaccine split im
0.015 MG, 0.06 MG — Prefilled Syringe
Also known as:
influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen
Fluzone High-Dose 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)
68 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Complete Gold
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Expanded Bronze
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Silver
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Gold
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Expanded Bronze with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Silver with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Gold with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Expanded Bronze + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Silver + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Gold + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Streamlined Silver with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Streamlined Silver
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Complete Gold | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver $0 Rx 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 |
| Signature Expanded Bronze | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Silver | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Gold | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Elite 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 |
| Signature Expanded Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver $0 Rx 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 |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Silver + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Streamlined Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Streamlined Silver | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | ✓ | QL |
AmeriHealth Caritas NC
30 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via influenza A virus A/Croatia/10136RV/2023 (H3N2) antigen |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Afluria 2025-2026 |
Brand-Preferred | — | — | — | None |
Oscar Health
56 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
AIAN Cost Share | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Classic | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple Diabetes | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple PCP Saver | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Gold Elite Saver Plus | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Simple Diabetes | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| AIAN Cost Share | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| AIAN Cost Share | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Gold Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Secure | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Classic 4700 | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Elite + PCP Saver Plus
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Classic
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Secure
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Classic 4700
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple PCP Saver
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Gold Elite Saver Plus
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple Diabetes
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Classic Standard
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Classic Standard
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Gold Classic Standard
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Classic Standard | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Classic Standard | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Gold Classic Standard | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Simple Chronic Care CKM | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Secure | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Classic 4700 | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Classic | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple Diabetes | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple PCP Saver | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Gold Elite Saver Plus | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Bronze Simple Diabetes | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
Silver Simple Chronic Care CKM | with Atrium Health
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
AIAN Cost Share
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Elite + PCP Saver Plus | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Classic | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Secure | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Classic 4700 | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple PCP Saver | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Gold Elite Saver Plus | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Simple Diabetes | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Bronze Classic Standard | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Silver Classic Standard | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| Gold Classic Standard | Tier 0 - $0 Preventive | — | — | ✓ | QL |
UnitedHealthcare
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Bronze Standard (HSA, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
| UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) | Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Afluria 2025-2026 |
Tier 0 - $0 Preventive | — | — | ✓ | QL |