mv-mins no.74/ferrous fumarate/iron ps cplx/folic acid
85 mg-1 mg — Capsule
Also known as:
CONCEPT OB
FOLIVANE-OB
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Bronze RD 5000 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Silver
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via Folivane-Ob |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via Folivane-Ob |
Tier 2 - Generic | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via Folivane-Ob |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Concept Ob |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Folivane-Ob |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Concept Ob |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Folivane-Ob |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Concept Ob |
Not Covered | — | — | — | None |