Nesina
Generic: alogliptin
12.5 MG, 25 MG, 6.25 MG — Tablet
Hypoglycemics - Oral — 2nd Generation Sulfonylureas
Also known as:
NESINA TABS 6.25MG, 12.5MG, 25MG
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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)
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Complete Gold
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Elite Bronze
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Clear Silver with $0 Insulin Options
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Expanded Bronze
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Silver
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Gold
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Expanded Bronze with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Silver with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Gold with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Complete Gold + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Elite Bronze + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Expanded Bronze + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Silver + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Gold + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Streamlined Silver with Atrium Health
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Streamlined Silver
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via alogliptin |
Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
AmeriHealth Caritas NC
21 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin benzoate |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 2 - Generic | — | — | ✓ | QL |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via alogliptin |
Tier 2 - Generic | — | — | ✓ | QL |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Standard Option 2026
via alogliptin benzoate |
Tier 1 - Generic | — | — | — | None |
|
BCBS Federal Focus 2026
via alogliptin benzoate |
Tier 1 - Generic | — | — | — | None |
|
BCBS Federal Basic Option 2026
via alogliptin benzoate |
Tier 1 - Generic | — | — | — | None |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via alogliptin benzoate |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via alogliptin benzoate |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via alogliptin benzoate |
Not Covered | — | — | — | None |
Oscar Health
54 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
69803NC0010074
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Chronic Care CKM | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700 | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Secure | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus with Adult Dental & Vision | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010076
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010077
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010078
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010079
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010080
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010081
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010082
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010083
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010084
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010085
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus with Adult Dental & Vision
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Core Plan
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Core Plan | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes with Adult Dental & Vision
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010108
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010109
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010110
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010111
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010112
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010113
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010114
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010115
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010116
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010117
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes with Adult Dental & Vision | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes with Adult Dental & Vision | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Chronic Care CKM | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010075
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard | with Atrium Health
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Secure
via alogliptin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic
via alogliptin |
Tier 2 - Generic | — | — | — | None |
TRICARE
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 3 - Non-Formulary | — | ✓ | — | ST Step therapy: 9DPP-4 INHIBITORS SECONDARY RULE- SEL DPP-4 INHIBITORS REQ PA W/O SELECT ANTI-HYPREGLYCEMIC |
|
TRICARE Uniform Formulary 2026
via alogliptin |
Tier 3 - Non-Formulary | — | ✓ | — | ST Step therapy: 9DPP-4 INHIBITORS SECONDARY RULE- SEL DPP-4 INHIBITORS REQ PA W/O SELECT ANTI-HYPREGLYCEMIC |