Maxitrol

Generic: neomycin-polymyxin- dexamethasone ophth

0.1% — Ointment

OPHTHALMIC AGENTS

Also known as: MAXITROL OIN 0.1% OP MAXITROL SUS 0.1% OP

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand None
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Local 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Care 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Value 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Advantage 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 1 - Lowest Cost Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - HDHP 2026 Tier 3 - Non-Preferred Brand None
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