Folivane-Ob

Generic: mv-mins no.74/ferrous fumarate/iron ps cplx/folic acid

Capsule

.12%

Also known as: FOLIVANE-OB CAP Folivane-Ob Capsule FOLIVANE-OB CAPSULE

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 22 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Bronze 6500 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Silver 3000 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Silver RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Silver 4400 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Silver RD 3500 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect myDiabetesCare Silver Tier 1 - Preferred Generic None
Connect Silver RD 2200 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Gold 1500 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect myDiabetesCare Bronze Tier 1 - Preferred Generic None
Connect Bronze 5500 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Bronze RD 6000 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Silver 3500 Indiv Med Deductible Tier 1 - Preferred Generic None
Connect Bronze CMS Standard Tier 2 - Generic None
Connect Silver CMS Standard Tier 2 - Generic None
Connect Silver RD CMS Standard Tier 2 - Generic None
Connect Gold CMS Standard Tier 2 - Generic None
Connect Bronze RD CMS Standard Tier 2 - Generic None
Connect Gold RD CMS Standard Tier 2 - Generic None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 22 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026
via Concept Ob
Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
NC State Health Plan - 80/20 Plus PPO 2026
via Concept Ob
Not Covered None
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026
via Concept Ob
Not Covered None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 22 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via mv-mins no.74/ferrous fumarate/iron ps cplx/folic acid
Tier 3 - Non-Formulary None
Something not right?