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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.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Standard Gold with Atrium Health + Vision + Adult Dental | 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 |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | 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 |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
Medicare Part D
16 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 28 days | QL |
| HealthSpring TotalCare (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 60 per 30 days | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Savings (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Plus (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 30 days | QL |
| Wellcare Simple Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| HealthSpring True Choice (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 30 days | QL |
| Wellcare Giveback Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Assist Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| Wellcare Simple (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 28 days | QL |
| HealthSpring Preferred (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Select (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 60 per 30 days | QL |