hydrocortisone acetate
Generic: Anucort-HC
25 MG — Suppository
CORTICOSTEROIDS-IMMUNE MODULATORS
Also known as:
HEMMOREX-HC
ANUSOL-HC
ANUCORT-HC
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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)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug 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 |
| Standard Expanded Bronze | Tier 2 - Generic | — | — | — | None |
| Standard Silver | Tier 2 - Generic | — | — | — | None |
| Standard 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 |
| Standard Expanded Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug 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 |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
Cigna
40 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect myDiabetesCare Silver
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect myDiabetesCare Silver
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via Anucort-HC |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Hemmorex-Hc |
Tier 2 - Generic | — | — | — | None |
TRICARE
1 planUnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |
| UHC Silver Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | — | None |