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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 |
|---|---|---|---|---|---|
| Everyday Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Focused Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 0 - $0 Preventive | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 0 - $0 Preventive | — | — | — | None |
Medicare Part D
25 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice H5216-211 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Full Access H5525-034 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice H5525-049 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice H5525-050 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice H5525-070 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| HumanaChoice H5525-083 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Choice H8145-004 (PFFS) | Tier 4 - Non-Preferred | — | — | — | None |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |