memantine hcl-donepezil hcl
10 mg — Capsule
Also known as:
memantine hcl-donepezil hcl cap er 24hr 14-10 mg
memantine hcl-donepezil hcl cap er 24hr 21-10 mg
memantine hcl-donepezil hcl cap er 24hr 28-10 mg
memantine hcl-donepezil hcl cap er 24hr 14-10
memantine hcl-donepezil hcl cap er 24hr 21-10
memantine hcl-donepezil hcl cap er 24hr 28-10
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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — | None |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |