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Antibiotics-Steroid Combinations

Also known as: Zylet
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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: 2 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver with Atrium Health + Vision + Adult Dental
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver with Atrium Health
via Zylet 		Tier 4 - Non-Preferred ✓ — — PA
Source: CMS QHP JSON  ·  Checked: 2 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Essential + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Signature + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Gold Signature + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Gold Premier + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 2 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Zylet 		Tier 2 - Preferred Brand — — — None
BCBS Federal Standard Option 2026
via Zylet 		Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Basic Option 2026
via Zylet 		Tier 3 - Non-Preferred Brand — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Zylet 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Zylet 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Zylet 		Tier 1 - Preferred Generic — — — None
Aetna Medicare Prime (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Dual (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Value Plus (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature Care (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Full Dual Care (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Enhanced (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Enhanced (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Enhanced (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature Extra (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature Giveback (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Signature (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Chronic Care (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring True Choice (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare Plus (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Select (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Savings (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Plus (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED DUAL 009 NC (HMO D-SNP)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CORE 001 NC (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED GIVEBACK 002 NC (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED GIVEBACK 012 NC (HMO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 001 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 003 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 005 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE 008 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Zylet 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Vitality Plan (PPO)
via Zylet 		Tier 4 - Non-Preferred — — — None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Zylet 		Tier 4 - Non-Preferred — — — None
HealthTeam Advantage Plan I (PPO)
via Zylet 		Tier 4 - Non-Preferred — — — None
HealthTeam Advantage Plan II (PPO)
via Zylet 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Zylet 		Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 2 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Zylet 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Zylet 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Zylet 		Not Covered — — — None
Source: CMS QHP JSON  ·  Checked: 1 hour, 55 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Gold Elite Saver Plus | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Classic 4700 | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Classic | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple Diabetes | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple PCP Saver | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Simple Chronic Care CKM | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Simple Diabetes | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple Chronic Care CKM | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
AIAN Cost Share
via Zylet 		Tier 4 - Non-Preferred — — — None
AIAN Cost Share | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Classic Standard
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Classic Standard
via Zylet 		Tier 4 - Non-Preferred — — — None
Gold Classic Standard
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Classic Standard | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Classic Standard | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Gold Classic Standard | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Elite + PCP Saver Plus
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Classic
via Zylet 		Tier 4 - Non-Preferred — — — None
Secure
via Zylet 		Tier 4 - Non-Preferred — — — None
Bronze Classic 4700
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple PCP Saver
via Zylet 		Tier 4 - Non-Preferred — — — None
Gold Elite Saver Plus
via Zylet 		Tier 4 - Non-Preferred — — — None
Silver Simple Diabetes
via Zylet 		Tier 4 - Non-Preferred — — — None
Secure | with Atrium Health
via Zylet 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 1 hour, 55 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Silver Standard (No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Bronze Standard (No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Gold Standard (No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Zylet 		Tier 4 - Non-Preferred — — — None
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