Nucynta Er

100 MG

Opioid Analgesics, Long-acting

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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: Jan 1, 2026  ·  Checked: 11 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze CMS Standard 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
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
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 11 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
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
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
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