naproxen
Generic: Naprosyn
250mg, 375mg, 500mg — Tablet
ANALGESICS - ANTI-INFLAMMATORY
Also known as:
naproxen oral suspension
naproxen oral tablet
naproxen oral tablet delayed release
Naprosyn
naproxen susp 125mg/5ml
naproxen tabs 250mg, 375mg, 500mg; tbec 375mg, 500mg
naproxen tab 250 mg, 375 mg
naproxen tab 500 mg
Naproxen 500 Mg Kit
Naproxen 250 Mg Tablet
Naproxen 375 Mg Tablet
Naproxen 500 Mg Tablet
Naproxen Dr 375 Mg Tablet
Naproxen Dr 500 Mg Tablet
naproxen susp 125mg/5ml; tabs 250mg, 375mg, 500mg; tbec 375mg, 500mg
naproxen tabs 250mg, 375mg, 500mg; tbec
Naproxen Oral Tablet
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 |
|---|---|---|---|---|---|
| Everyday Bronze | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold | 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 |
| 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 Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Gold with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Gold | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Silver | Tier 2 - Generic | — | — | ✓ | QL |
| Standard Expanded Bronze | Tier 2 - Generic | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 2 - Generic | — | — | ✓ | QL |
| Elite Bronze | Tier 2 - Generic | — | — | ✓ | QL |
AmeriHealth Caritas NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Naprosyn |
Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — | None |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Local 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Value 2026
via Naprosyn |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Care 2026
via Naprosyn |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Local 2026
via Naprosyn |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Naprosyn |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Naprosyn |
Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Silver 3500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 2 - Generic | — | — | — | None |
Medicare Part D
140 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Liberty (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Freedom (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Signature (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CORE 001 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 001 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 003 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 005 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 008 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Simple Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Simple (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Giveback Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Plan I (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Plan II (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Assist Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5216-211 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Full Access H5525-034 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-049 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-050 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-070 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-083 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Choice H8145-004 (PFFS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Senior Care (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Troy Medicare (HMO) | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| HealthSpring TotalCare (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Savings (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Select (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Plus (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring True Choice (PPO) | Tier 3 - Preferred Brand | — | — | — | None |
| Blue Medicare Essential Plus (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Blue Medicare Enhanced (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Blue Medicare Choice (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Blue Medicare Essential (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Healthy Blue + Medicare (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health Platinum (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health smartHMO (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Experience Health Medicare Advantage (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature Giveback (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health Platinum Select (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Alignment Health AVA (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Dual (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Enhanced (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature Care (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Prime (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Value Plus (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 1800 per 30 days | PA | QL |
| Blue Medicare PPO Enhanced (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 1800 per 30 days | QL |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| AIAN Cost Share | Tier 1 - Preferred Generic | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Classic | Tier 1 - Preferred Generic | — | — | — | None |
| Secure | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Classic 4700 | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple PCP Saver | Tier 1 - Preferred Generic | — | — | — | None |
| Gold Elite Saver Plus | Tier 1 - Preferred Generic | — | — | — | None |
| Silver Simple Diabetes | Tier 1 - Preferred Generic | — | — | — | None |
| Secure | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 1 - Preferred Generic | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | Tier 2 - Generic | — | — | — | None |
TRICARE
1 planUnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Gold Standard (No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Bronze Standard (No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Standard (No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 1 - Preferred Generic | — | — | — | None |