Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
11 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
Medicare Part D
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
HealthSpring True Choice (PPO)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring Preferred (HMO)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring TotalCare (HMO D-SNP)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring Preferred Plus (HMO)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring Preferred Savings (HMO)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
|
HealthSpring Preferred Select (HMO)
via Jascayd |
Tier 5 - Specialty | ✓ | — | ✓ 60 per 30 days | PA | QL |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via Jascayd |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Jascayd |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Jascayd |
Not Covered | — | — | — | None |