nilotinib d-tartrate

150 mg, 200 mg, 50 mg — Capsule

ONCOLOGICAL AGENTS

Also known as: NILOTINIB D-TARTRATE CAPS 50MG, 150MG, 200MG
GoodRx Compare Prices

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 19 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Standard Option 2026 Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Basic Option 2026 Tier 4 - Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 19 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Gold RD CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Silver Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 2200 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold 1500 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 5500 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD 6000 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3500 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD 5000 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 3500 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 7000 HSA Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 4400 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 5000 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3000 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 6500 Indiv Med Deductible Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver CMS Standard Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 19 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Humana Gold Plus H1036-137 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice Giveback H5216-017 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice H5216-211 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Full Access H5525-034 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice Giveback H5525-035 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice H5525-049 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice H5525-050 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice H5525-070 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HumanaChoice H5525-083 (PPO) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H6622-025 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Choice H8145-004 (PFFS) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Aetna Medicare Signature (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Dual (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Value Plus (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Prime (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature Care (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Enhanced (HMO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Enhanced (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature Extra (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature Giveback (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Signature (PPO) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
HealthTeam Advantage Plan I (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Plan II (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Vitality Plan (PPO) Tier 5 - Specialty ✓ — — PA
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 5 - Specialty ✓ — — PA
Troy Medicare (HMO) Tier 5 - Specialty ✓ — — PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 112 per 28 days PA | QL
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 19 hours, 44 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
Something not right?