Niva Thyroid

Generic: thyroid

120 Mg — Tablet

Also known as: Niva Thyroid 15 Mg Tablet Niva Thyroid 30 Mg Tablet Niva Thyroid 60 Mg Tablet Niva Thyroid 90 Mg Tablet Niva Thyroid 120 Mg Tablet thyroid (USP)

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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)

102 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Focused Silver with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold via Amerithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver with Atrium Health via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental via Armour Thyroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Silver with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Signature Gold with Atrium Health + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver with Atrium Health via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Streamlined Silver via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental via Evexithroid	Tier 3 - Preferred Brand	—	—	✓	QL

Blue Cross Blue Shield Federal

6 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Focus 2026 via Thyroid	Tier 2 - Preferred Brand	—	—	—	None
BCBS Federal Focus 2026 via Armour Thyroid	Tier 2 - Preferred Brand	—	—	—	None
BCBS Federal Standard Option 2026 via Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Basic Option 2026 via Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Basic Option 2026 via Armour Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Standard Option 2026 via Armour Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None

Blue Cross Blue Shield of NC

55 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026 via Np Thyroid 30	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Np Thyroid 30	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Np Thyroid 30	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Np Thyroid 15	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Np Thyroid 15	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Np Thyroid 15	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Np Thyroid 15	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Np Thyroid 15	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Np Thyroid 120	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Np Thyroid 120	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Np Thyroid 120	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Np Thyroid 120	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Np Thyroid 120	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Np Thyroid 60	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Np Thyroid 60	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Np Thyroid 60	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Np Thyroid 60	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Np Thyroid 30	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Np Thyroid 30	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Armour Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Armour Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Armour Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Armour Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Armour Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Np Thyroid 60	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Thyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Renthyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Amerithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Amerithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Amerithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Amerithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Amerithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Renthyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Renthyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Renthyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Renthyroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Evexithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Evexithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Evexithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Evexithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Evexithroid	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Np Thyroid 90	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Np Thyroid 90	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Np Thyroid 90	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Np Thyroid 90	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Np Thyroid 90	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 3 - High Cost Brand	—	—	—	None

Cigna

60 plans

Source: PDF · Formulary date: Oct 7, 2026 · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Connect myDiabetesCare Bronze via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver 3600 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Silver 3000 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Bronze CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Gold 1500 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Silver CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Gold RD CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver RD CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Silver	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Bronze	Tier 2 - Generic	—	—	—	None
Connect Gold CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Silver RD CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Gold RD CMS Standard	Tier 2 - Generic	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Gold CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver 3600 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver 5000 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze RD CMS Standard via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Silver 5000 Indiv Med Deductible	Tier 2 - Generic	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Thyroid	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Silver via Thyroid	Tier 2 - Generic	—	—	—	None
Connect myDiabetesCare Bronze via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 5000 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3600 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Silver via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold RD CMS Standard via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Armour Thyroid	Tier 3 - Preferred Brand	—	—	—	None

NC State Health Plan

30 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026 via Np Thyroid 60	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Armour Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Armour Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Armour Thyroid	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Np Thyroid 120	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Np Thyroid 30	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Np Thyroid 90	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Np Thyroid 90	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Np Thyroid 90	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Np Thyroid 30	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Np Thyroid 30	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Np Thyroid 120	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Np Thyroid 15	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Np Thyroid 15	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Np Thyroid 15	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - HDHP 2026 via Np Thyroid 120	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Np Thyroid 60	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Np Thyroid 60	Tier 3 - Non-Preferred Brand	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Evexithroid	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Evexithroid	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Amerithroid	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Amerithroid	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Amerithroid	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Thyroid	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Thyroid	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Thyroid	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Renthyroid	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Renthyroid	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Renthyroid	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Evexithroid	Not Covered	—	—	—	None

Oscar Health

84 plans

Source: CMS QHP JSON · Checked: 4 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Silver Simple Diabetes	Tier 2 - Generic	—	—	—	None
AIAN Cost Share \| with Atrium Health	Tier 2 - Generic	—	—	—	None
AIAN Cost Share	Tier 2 - Generic	—	—	—	None
Silver Simple Women's Health with Menopause Benefits \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Simple Chronic Care CKM \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Simple Diabetes \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Simple Diabetes \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Classic \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700 \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Secure \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Simple Chronic Care CKM \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Gold Classic Standard \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Silver Classic Standard \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard \| with Atrium Health	Tier 2 - Generic	—	—	—	None
Gold Classic Standard	Tier 2 - Generic	—	—	—	None
Silver Classic Standard	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700	Tier 2 - Generic	—	—	—	None
Secure	Tier 2 - Generic	—	—	—	None
Silver Classic	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Classic via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Secure via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700 via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple Diabetes via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Classic Standard via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Gold Classic Standard via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Classic Standard \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Gold Classic Standard \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Simple Chronic Care CKM \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Secure \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700 \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Classic \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple Diabetes \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Simple Diabetes \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple Chronic Care CKM \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Silver Simple Women's Health with Menopause Benefits \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
AIAN Cost Share via thyroid (USP)	Tier 2 - Generic	—	—	—	None
AIAN Cost Share \| with Atrium Health via thyroid (USP)	Tier 2 - Generic	—	—	—	None
Bronze Simple Diabetes \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple Diabetes \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Classic \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700 \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Secure \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Simple Chronic Care CKM \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Gold Classic Standard \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Classic Standard \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Gold Classic Standard via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Classic Standard via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Classic Standard via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple Diabetes via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Gold Elite Saver Plus via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple PCP Saver via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Classic 4700 via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Secure via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Classic via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Bronze Elite + PCP Saver Plus via Armour Thyroid	Tier 2 - Generic	—	—	—	None
AIAN Cost Share \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
AIAN Cost Share via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple Women's Health with Menopause Benefits \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple Chronic Care CKM \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None
Silver Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health via Armour Thyroid	Tier 2 - Generic	—	—	—	None

UnitedHealthcare

51 plans

Source: PDF · Formulary date: Sep 23, 2026 · Checked: 4 hours, 15 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard (HSA, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard (HSA, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) via thyroid (USP)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) via Armour Thyroid	Tier 4 - Non-Preferred	—	—	—	None