Onglyza

Generic: saxagliptin

2.5MG, 5MG — Tablet

Hypoglycemics - Oral — 2nd Generation Sulfonylureas

Also known as: ONGLYZA TABS 2.5MG, 5MG ONGLYZA TABS 5MG

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

Ambetter (Centene)

29 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 20 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Silver with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Gold with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Complete Gold + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Expanded Bronze + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Silver + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Gold + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Silver with Atrium Health + Vision + Adult Dental via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Complete Gold via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Everyday Bronze via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Elite Bronze via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Clear Silver with $0 Insulin Options via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Expanded Bronze via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Silver via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Gold via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Everyday Bronze with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Elite Bronze with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Focused Silver with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Complete Gold with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL
Standard Expanded Bronze with Atrium Health via saxagliptin	Tier 2 - Generic	—	—	✓	QL

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 20 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via saxagliptin	Tier 1 - Generic	—	—	✓	QL

Medicare Part D

9 plans

Source: CMS QHP JSON · Formulary date: Mar 18, 2026 · Checked: 20 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Longevity Health Plan (HMO I-SNP) via saxagliptin	Tier 1 - Preferred Generic	—	—	✓ 30 per 30 days	QL
Wellcare Dual Liberty (HMO-POS D-SNP) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Dual Access (HMO-POS D-SNP) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Simple Open (PPO) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Simple (HMO-POS) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Giveback Open (PPO) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Assist Open (PPO) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Dual Liberty Open (PPO D-SNP) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL
Wellcare Dual Reserve (HMO-POS D-SNP) via saxagliptin	Tier 3 - Preferred Brand	—	—	✓ 30 per 30 days	QL

NC Medicaid PDL

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	—	—	—	None
NC Medicaid Preferred Drug List 2026 via saxagliptin	Non-Preferred	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 36 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