Lenvima

Generic: lenvatinib

4 Mg, 10 Mg, 10 Mg — Capsule

ANTINEOPLASTICS

Also known as: Lenvima Oral Capsule Therapy Pack 10 & 4 Mg, 10 Mg, 10 Mg & 2 X LENVIMA 4 MG DAILY DOSE CPPK 4MG LENVIMA 8 MG DAILY DOSE CPPK 4MG LENVIMA 10 MG DAILY DOSE CPPK 10MG LENVIMA 12MG DAILY DOSE CPPK 4MG LENVIMA 20 MG DAILY DOSE CPPK 10MG LENVIMA CAP 14 MG LENVIMA CAP 18 MG LENVIMA CAP 24 MG Lenvima 10 Mg Daily Dose Lenvima 12Mg Daily Dose Lenvima 14 Mg Daily Dose Lenvima 18 Mg Daily Dose Lenvima 20 Mg Daily Dose Lenvima 24 Mg Daily Dose Lenvima 4 Mg Daily Dose Lenvima 8 Mg Daily Dose Lenvima 4 Mg Capsule Lenvima 12 Mg Daily Dose lenvatinib
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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  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Elite Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Standard Option 2026 Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Basic Option 2026 Tier 4 - Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026 Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Value 2026 Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Advantage 2026 Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Local 2026 Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 4 - Specialty ✓ — ✓ Limited Distribution; Specialty Pharmacy Required PA | QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Giveback (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care (HMO C-SNP) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 5 - Specialty ✓ — — PA
HealthSpring True Choice (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Select (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CORE 001 NC (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED GIVEBACK 002 NC (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED GIVEBACK 012 NC (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE 001 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE 003 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE 005 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE 008 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 009 NC (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Simple Open (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Simple (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Giveback Open (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Blue Medicare PPO Enhanced (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Blue Medicare Essential Plus (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Blue Medicare Enhanced (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Blue Medicare Choice (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Blue Medicare Essential (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Experience Health Medicare Advantage (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health Platinum (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health smartHMO (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health Platinum Select (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Alignment Health AVA (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthTeam Advantage Plan I (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Plan II (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Vitality Plan (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 5 - Specialty ✓ — — PA
Troy Medicare (HMO) Tier 5 - Specialty ✓ — — PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Dual Liberty Open (PPO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Assist Open (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Dual Access (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Senior Care (HMO I-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 5 - Specialty ✓ — — PA
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 5 - Specialty ✓ — — PA
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 5 - Specialty ✓ — — PA
Erickson Advantage Signature (HMO-POS) Tier 5 - Specialty ✓ — — PA
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 5 - Specialty ✓ — — PA
Erickson Advantage Freedom (HMO-POS) Tier 5 - Specialty ✓ — — PA
Erickson Advantage Liberty (HMO-POS) Tier 5 - Specialty ✓ — — PA
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 5 - Specialty ✓ — — PA
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 5 - Specialty ✓ — — PA
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 5 - Specialty ✓ — — PA
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 5 - Specialty ✓ — — PA
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 5 - Specialty ✓ — — PA
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 5 - Specialty ✓ — — PA
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 5 - Specialty ✓ — — PA
Erickson Advantage Champion (HMO-POS C-SNP) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Dual (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Value Plus (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Prime (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Care (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (HMO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Extra (PPO) Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — — PA
HumanaChoice H5525-050 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice H5525-070 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice H5525-083 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H6622-025 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Choice H8145-004 (PFFS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H1036-137 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice Giveback H5216-017 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice H5216-211 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Humana Full Access H5525-034 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice Giveback H5525-035 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HumanaChoice H5525-049 (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026 Tier 5 - Preferred Brand Specialty ✓ — ✓ PA | QL
NC State Health Plan - 70/30 Standard PPO 2026 Tier 5 - Preferred Brand Specialty ✓ — ✓ PA | QL
NC State Health Plan - 80/20 Plus PPO 2026 Tier 5 - Preferred Brand Specialty ✓ — ✓ PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours, 16 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026 Unknown ✓ — ✓ PA | QL
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