nicotine polacrilex gum
2 mg, 4 mg
ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS
Also known as:
nicotine polacrilex gum 2 mg, 4 mg
nicotine polacrilex gum 2mg, 4mg; lozg 2mg, 4mg
nicotine polacrilex gum 2mg, 4mg; lozg 2mg,
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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.
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier A - ACA $0 Copay | — | — | — | None |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |