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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.
Source: CMS QHP JSON  ·  Checked: 18 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 2 - Generic — ✓ — ST
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 2 - Generic — ✓ — ST
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 18 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Blue Medicare Essential Plus (HMO-POS) Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Enhanced (HMO-POS) Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Choice (HMO) Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare Essential (HMO) Tier 4 - Non-Preferred ✓ — — PA
Experience Health Medicare Advantage (HMO) Tier 4 - Non-Preferred ✓ — — PA
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 4 - Non-Preferred ✓ — — PA
Blue Medicare PPO Enhanced (PPO) Tier 4 - Non-Preferred ✓ — — PA
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