naloxone syringe / spray

Vial

Opioid Antagonists

Also known as: Narcan
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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.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 15 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Everyday Bronze
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Elite Bronze
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Expanded Bronze
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Silver
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Gold
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Everyday Bronze with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Elite Bronze with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Focused Silver with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Complete Gold
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Expanded Bronze with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Silver with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Gold with Atrium Health
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Complete Gold + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Elite Bronze + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Silver + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Gold + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Clear Silver with $0 Insulin Options
via Narcan 		Tier 4 - Non-Preferred — — ✓ QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 15 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred — — — None
NC Medicaid Preferred Drug List 2026
via Narcan 		Preferred — — — None
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 15 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Silver Standard (No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Gold Standard (No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
UHC Bronze Standard (No Referrals)
via Narcan 		Tier 0 - $0 Preventive — — — None
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