ketorolac tromethamine

Generic: Acuvail

15.75 mg/spray — Tablet

ANALGESICS - ANTI-INFLAMMATORY

Also known as: ketorolac tromethamine oral ketorolac tromethamine soln 15mg/ml, 30mg/ml, 60mg/2ml; tabs 10mg ketorolac tromethamine tab 10 mg ketorolac tromethamine tabs 10mg SPRIX ketorolac tromethamine soln 15mg/ml, Ketorolac Tromethamine Oral Tablet
GoodRx Compare Prices

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  ·  Formulary date: Jan 1, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Expanded Bronze with Atrium Health Tier 2 - Generic — — — None
Standard Gold with Atrium Health + 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
Standard Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Gold + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Silver + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Expanded Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 2 - Generic — — — None
Standard Gold with Atrium Health Tier 2 - Generic — — — None
Standard Silver with Atrium Health 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
Source: CMS QHP JSON  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 2 - Generic — — ✓ QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 1 - Generic — — — None
BCBS Federal Focus 2026 Tier 1 - Generic — — — None
BCBS Federal Basic Option 2026 Tier 1 - Generic — — — None
BCBS Federal Standard Option 2026
via Acuvail 		Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Basic Option 2026
via Acuvail 		Tier 3 - Non-Preferred Brand — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Advantage 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Value 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Care 2026 Tier 1 - Lowest Cost Generic — — — None
BCBSNC Blue Local 2026 Tier 1 - Lowest Cost Generic — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Advantage (HMO C-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 30 days QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
Senior Care (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 5 days QL
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 30 days QL
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 20 per 30 days QL
HumanaChoice H5525-049 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
Aetna Medicare Signature (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Dual (HMO D-SNP) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Value Plus (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Prime (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature Care (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Enhanced (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Enhanced (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Enhanced (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature Extra (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature Giveback (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Signature (PPO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Alignment Health Platinum (HMO) Tier 2 - Generic — — — None
Alignment Health NC Duals (HMO-POS D-SNP) Tier 2 - Generic — — — None
Alignment Health smartHMO (HMO) Tier 2 - Generic — — — None
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 2 - Generic — — — None
Alignment Health Platinum Select (HMO) Tier 2 - Generic — — — None
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 2 - Generic — — — None
Alignment Health AVA (PPO) Tier 2 - Generic — — — None
Troy Medicare (HMO) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 2 - Generic ✓ — ✓ 20 per 30 days PA | QL
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H1036-137 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice Giveback H5216-017 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice H5216-211 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Full Access H5525-034 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice Giveback H5525-035 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice H5525-050 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice H5525-070 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
HumanaChoice H5525-083 (PPO) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H6622-025 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Choice H8145-004 (PFFS) Tier 2 - Generic — — ✓ 20 per 30 days QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 2 - Generic — — ✓ 20 per 30 days QL
HealthTeam Advantage Plan II (PPO) Tier 4 - Non-Preferred — — ✓ 20 per 30 days QL
HealthTeam Advantage Plan I (PPO) Tier 4 - Non-Preferred — — ✓ 20 per 30 days QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 20 per 30 days QL
HealthTeam Advantage Vitality Plan (PPO) Tier 4 - Non-Preferred — — ✓ 20 per 30 days QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Acuvail 		Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Tier 1 - Preferred Generic — — — None
NC State Health Plan - 80/20 Plus PPO 2026 Tier 1 - Preferred Generic — — — None
NC State Health Plan - HDHP 2026 Tier 1 - Preferred Generic — — — None
Source: CMS QHP JSON  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Gold Classic Standard Tier 2 - Generic — — — None
Bronze Classic Standard | with Atrium Health Tier 2 - Generic — — — None
Silver Classic Standard | with Atrium Health Tier 2 - Generic — — — None
Gold Classic Standard | with Atrium Health Tier 2 - Generic — — — None
Bronze Elite + PCP Saver Plus Tier 2 - Generic — — — None
Silver Classic Tier 2 - Generic — — — None
Secure Tier 2 - Generic — — — None
Bronze Classic 4700 Tier 2 - Generic — — — None
Silver Simple PCP Saver Tier 2 - Generic — — — None
Gold Elite Saver Plus Tier 2 - Generic — — — None
Silver Simple Diabetes Tier 2 - Generic — — — None
Secure | with Atrium Health Tier 2 - Generic — — — None
Bronze Classic 4700 | with Atrium Health Tier 2 - Generic — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 2 - Generic — — — None
Silver Classic | with Atrium Health Tier 2 - Generic — — — None
Silver Simple Diabetes | with Atrium Health Tier 2 - Generic — — — None
Silver Simple PCP Saver | with Atrium Health Tier 2 - Generic — — — None
Gold Elite Saver Plus | with Atrium Health Tier 2 - Generic — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 2 - Generic — — — None
Bronze Simple Diabetes | with Atrium Health Tier 2 - Generic — — — None
Bronze Simple Chronic Care CKM | with Atrium Health Tier 2 - Generic — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 2 - Generic — — — None
Silver Simple Chronic Care CKM | with Atrium Health Tier 2 - Generic — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 2 - Generic — — — None
AIAN Cost Share Tier 2 - Generic — — — None
AIAN Cost Share | with Atrium Health Tier 2 - Generic — — — None
Bronze Classic Standard Tier 2 - Generic — — — None
Silver Classic Standard Tier 2 - Generic — — — None
Secure | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Classic | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple Diabetes | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple PCP Saver | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Gold Elite Saver Plus | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Simple Chronic Care CKM | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Simple Diabetes | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple Chronic Care CKM | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
AIAN Cost Share
via Acuvail 		Tier 3 - Preferred Brand — — — None
AIAN Cost Share | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Classic Standard
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Classic Standard
via Acuvail 		Tier 3 - Preferred Brand — — — None
Gold Classic Standard
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Classic Standard | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Classic Standard | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Gold Classic Standard | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Elite + PCP Saver Plus
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Classic
via Acuvail 		Tier 3 - Preferred Brand — — — None
Secure
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Classic 4700
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple PCP Saver
via Acuvail 		Tier 3 - Preferred Brand — — — None
Gold Elite Saver Plus
via Acuvail 		Tier 3 - Preferred Brand — — — None
Silver Simple Diabetes
via Acuvail 		Tier 3 - Preferred Brand — — — None
Bronze Classic 4700 | with Atrium Health
via Acuvail 		Tier 3 - Preferred Brand — — — None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary — — ✓ QL
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 22 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Bronze Standard (No Referrals) Tier 1 - Preferred Generic — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals Tier 1 - Preferred Generic — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Silver Standard (No Referrals) Tier 1 - Preferred Generic — — — None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Gold Standard (No Referrals) Tier 1 - Preferred Generic — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals) Tier 1 - Preferred Generic — — — None
UHC Bronze Standard+ Dental + Vision (No Referrals) Tier 1 - Preferred Generic — — — None
Something not right?