Odactra
Generic: dust mite mixed ext sl
Sublingual Tablet
Also known as:
American house dust mite allergenic extract
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 4 - Higher Cost Brand | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Bronze CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver RD CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Gold CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Gold RD CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect myDiabetesCare Silver | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Gold 1500 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect myDiabetesCare Bronze | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze 5500 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver 4400 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver 3000 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Bronze 6500 Indiv Med Deductible | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
| Connect Silver CMS Standard | Tier 4 - Non-Preferred | ✓ | — | ✓ | PA | QL |
Medicare Part D
4 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| HealthTeam Advantage Plan II (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 30 per 30 days | PA | QL |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 30 per 30 days | PA | QL |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 30 per 30 days | PA | QL |
| HealthTeam Advantage Plan I (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 30 per 30 days | PA | QL |