Nucynta

Generic: tapentadol

50MG, 100MG, 150MG, 200MG, 250MG — Tablet

OPIOID AGONISTS

Also known as: tapentadol NUCYNTA TABS 50MG, 75MG, 100MG NUCYNTA ER TB12 50MG, 100MG, 150MG, 200MG, 250MG Nucynta Er 50 Mg Tablet Nucynta Er 100 Mg Tablet Nucynta Er 150 Mg Tablet Nucynta Er 200 Mg Tablet Nucynta Er 250 Mg Tablet NUCYNTA ER TB12 50MG, 100MG NUCYNTA ER TB12 150MG, 200MG, 250MG NUCYNTA ER TB12 50MG, 100MG, 150MG,
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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.
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 21 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Basic Option 2026 Tier 2 - Preferred Brand ✓ — — PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 21 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Silver Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Gold 1500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Bronze Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 4400 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Gold CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Gold RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 21 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Alignment Health Platinum Select (HMO) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health AVA (PPO) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health Platinum (HMO) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health smartHMO (HMO) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 5 - Specialty ✓ — ✓ 60 per 30 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 21 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026 Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered — — — None
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 21 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Silver Standard (No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Gold Standard (No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Bronze Standard+ Dental + Vision (No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
UHC Bronze Standard (No Referrals) Tier 4 - Non-Preferred ✓ — ✓ PA | QL
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