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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.
AmeriHealth Caritas NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 3 - Preferred Brand | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Harvoni |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Harvoni |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Harvoni |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Harvoni |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Value 2026
via Harvoni |
Tier 3 - High Cost Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Advantage 2026
via Harvoni |
Tier 3 - High Cost Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Harvoni |
Tier 3 - High Cost Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Local 2026
via Harvoni |
Tier 3 - High Cost Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Care 2026
via Harvoni |
Tier 3 - High Cost Brand | ✓ | — | — Restricted Access | PA |
Medicare Part D
23 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring TotalCare (HMO D-SNP)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred (HMO)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Select (HMO)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Assist Open (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Savings (HMO)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Plus (HMO)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Simple Open (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Simple (HMO-POS) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Wellcare Giveback Open (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Alignment Health Platinum (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health smartHMO (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Platinum Select (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring True Choice (PPO)
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
| Alignment Health AVA (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Harvoni |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Harvoni |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Harvoni |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Gold Classic Standard
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Gold Classic Standard | with Atrium Health
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Bronze Classic Standard
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Silver Classic Standard
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Silver Classic Standard | with Atrium Health
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Bronze Classic Standard | with Atrium Health
via Harvoni |
Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
|
Gold Elite Saver Plus | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Elite + PCP Saver Plus
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Classic
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Secure
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Classic 4700
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple PCP Saver
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Gold Elite Saver Plus
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple Diabetes
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Secure | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Classic 4700 | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Classic | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple Diabetes | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple PCP Saver | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Simple Chronic Care CKM | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Bronze Simple Diabetes | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple Chronic Care CKM | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AIAN Cost Share
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AIAN Cost Share | with Atrium Health
via Harvoni |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
UnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Bronze Standard (No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Silver Standard (No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Gold Standard (No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |