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 Federal
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Standard Option 2026
via Zyprexa |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
BCBS Federal Basic Option 2026
via Zyprexa |
Tier 3 - Non-Preferred Brand | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Local 2026
via Zyprexa |
Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
|
BCBSNC Blue Value 2026
via Zyprexa |
Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
|
BCBSNC Blue Advantage 2026
via Zyprexa |
Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
|
BCBSNC Blue Care 2026
via Zyprexa |
Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Zyprexa |
Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
Medicare Part D
25 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H6622-057 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H6622-060 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H6622-061 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Choice H8145-004 (PFFS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H1036-137 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H1036-233 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Dual Select H1036-307 (HMO D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H1036-335 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice Giveback H5216-017 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice H5216-211 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Full Access H5525-034 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice Giveback H5525-035 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice H5525-049 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice H5525-050 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice H5525-070 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Dual Select H5525-072 (PPO D-SNP)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
HumanaChoice H5525-083 (PPO)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H6622-025 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
|
Humana Gold Plus H6622-026 (HMO-POS)
via Zyprexa |
Tier 4 - Non-Preferred | — | — | — | None |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Zyprexa |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Zyprexa |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Zyprexa |
Tier 3 - Non-Preferred Brand | — | — | — | None |