nilotinib hcl

50 mg, 150 mg, 200 mg — Capsule

ANTINEOPLASTICS

Also known as: Nilotinib HCl Oral Capsule nilotinib hcl cap 50 mg (base equivalent), 150 mg (base equivalent), 200 mg (base equivalent) Nilotinib Hcl 50 Mg Capsule Nilotinib Hcl 150 Mg Capsule Nilotinib Hcl 200 Mg Capsule nilotinib hcl caps 50mg, 150mg, 200mg

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 13 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty PA | QL
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty PA | QL
Source: PDF  ·  Formulary date: Aug 7, 2026  ·  Checked: 13 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand PA
BCBS Federal Basic Option 2026 Tier 4 - Preferred Specialty PA
BCBS Federal Standard Option 2026 Tier 4 - Preferred Specialty PA
Source: CMS QHP JSON  ·  Formulary date: Aug 19, 2026  ·  Checked: 13 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic 112 per 28 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic 112 per 28 days PA | QL
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic 112 per 28 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic 112 per 28 days PA | QL
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
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic 112 per 28 days PA | QL
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic PA
Aetna Medicare Full Dual Care (HMO D-SNP) 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 Enhanced (HMO) 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
Blue Medicare PPO Enhanced (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Essential Plus (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Enhanced (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Choice (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Essential (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Wellcare Simple (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Dual Access (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Senior Care (HMO I-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Troy Medicare (HMO) Tier 5 - Specialty PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 5 - Specialty PA
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
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Humana Gold Plus H1036-233 (HMO-POS) 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 H1036-307 (HMO D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Humana Gold Plus H1036-137 (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Platinum (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health smartHMO (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Platinum Select (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
DEVOTED CORE 001 NC (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED GIVEBACK 002 NC (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED GIVEBACK 012 NC (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) 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
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
Humana Dual Select H5525-072 (PPO D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
HumanaChoice H5525-083 (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
Erickson Advantage Signature (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Erickson Advantage Champion (HMO-POS C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Erickson Advantage Freedom (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
Erickson Advantage Liberty (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty 112 per 28 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
Alignment Health AVA (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring True Choice (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
Humana Gold Choice H8145-004 (PFFS) Tier 5 - Specialty 120 per 30 days PA | QL
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
DEVOTED CHOICE 001 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE 003 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE 005 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED CHOICE 008 NC (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
HealthTeam Advantage Vitality Plan (PPO) Tier 5 - Specialty PA
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring Preferred (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring Preferred Select (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty 112 per 28 days PA | QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
DEVOTED CHOICE GIVEBACK 009 NC (PPO) 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
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 5 - Specialty PA
Experience Health Medicare Advantage (HMO) 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
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Simple Open (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Dual Liberty Open (PPO D-SNP) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Assist Open (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
Wellcare Giveback Open (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 5 - Specialty 112 per 28 days PA | QL
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 5 - Specialty 112 per 28 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
Something not right?