methamphetamine hydrochloride

5 MG — Tablet

Amphetamine Anorectic

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: 14 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Elite Bronze + Vision + Adult Dental Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 2 - Generic QL
Complete Gold Tier 2 - Generic QL
Standard Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Standard Gold + Vision + Adult Dental Tier 2 - Generic QL
Standard Silver + Vision + Adult Dental Tier 2 - Generic QL
Standard Expanded Bronze + Vision + Adult Dental Tier 2 - Generic QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic QL
Everyday Bronze Tier 2 - Generic QL
Elite Bronze Tier 2 - Generic QL
Clear Silver with $0 Insulin Options Tier 2 - Generic QL
Standard Expanded Bronze Tier 2 - Generic QL
Standard Silver Tier 2 - Generic QL
Standard Gold Tier 2 - Generic QL
Everyday Bronze with Atrium Health Tier 2 - Generic QL
Elite Bronze with Atrium Health Tier 2 - Generic QL
Focused Silver with Atrium Health Tier 2 - Generic QL
Complete Gold with Atrium Health Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health Tier 2 - Generic QL
Standard Silver with Atrium Health Tier 2 - Generic QL
Standard Gold with Atrium Health Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 2 - Generic QL
Complete Gold + Vision + Adult Dental Tier 2 - Generic QL
Everyday Bronze + Vision + Adult Dental Tier 2 - Generic QL
Source: CMS QHP JSON  ·  Checked: 14 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AIAN Cost Share | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Classic 4700 | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 4 - Non-Preferred QL
Silver Classic | with Atrium Health Tier 4 - Non-Preferred QL
Silver Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred QL
Silver Simple PCP Saver | with Atrium Health Tier 4 - Non-Preferred QL
Gold Elite Saver Plus | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred QL
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred QL
Silver Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred QL
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 4 - Non-Preferred QL
AIAN Cost Share Tier 4 - Non-Preferred QL
Bronze Classic Standard Tier 4 - Non-Preferred QL
Silver Classic Standard Tier 4 - Non-Preferred QL
Gold Classic Standard Tier 4 - Non-Preferred QL
Bronze Classic Standard | with Atrium Health Tier 4 - Non-Preferred QL
Silver Classic Standard | with Atrium Health Tier 4 - Non-Preferred QL
Gold Classic Standard | with Atrium Health Tier 4 - Non-Preferred QL
Bronze Elite + PCP Saver Plus Tier 4 - Non-Preferred QL
Silver Classic Tier 4 - Non-Preferred QL
Secure Tier 4 - Non-Preferred QL
Bronze Classic 4700 Tier 4 - Non-Preferred QL
Silver Simple PCP Saver Tier 4 - Non-Preferred QL
Gold Elite Saver Plus Tier 4 - Non-Preferred QL
Silver Simple Diabetes Tier 4 - Non-Preferred QL
Secure | with Atrium Health Tier 4 - Non-Preferred QL
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 14 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Bronze Standard (No Referrals) Tier 4 - Non-Preferred PA
UHC Silver Value ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred PA
UHC Silver Standard (No Referrals) Tier 4 - Non-Preferred PA
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred PA
UHC Bronze Standard+ Dental + Vision (No Referrals) Tier 4 - Non-Preferred PA
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred PA
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred PA
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals Tier 4 - Non-Preferred PA
UHC Gold Standard (No Referrals) Tier 4 - Non-Preferred PA
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred PA
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) Tier 4 - Non-Preferred PA
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred PA
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred PA
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