oxymorphone hydrochloride
Generic: oxymorphone hcl
7.5 MG — Extended Release Tablet
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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.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Elite Bronze with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Complete Gold | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Everyday Bronze | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Elite Bronze | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Expanded Bronze | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Silver | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Gold | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Focused Silver with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Complete Gold with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Expanded Bronze with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Silver with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Standard Gold with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via oxymorphone hcl |
Tier 1 - Generic | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via oxymorphone hcl |
Tier 1 - Generic | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via oxymorphone hcl |
Tier 1 - Generic | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Care 2026
via oxymorphone hcl |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Value 2026
via oxymorphone hcl |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Advantage 2026
via oxymorphone hcl |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via oxymorphone hcl |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Local 2026
via oxymorphone hcl |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
| BCBSNC Blue Care 2026 | Tier 4 - Higher Cost Brand | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Value 2026 | Tier 4 - Higher Cost Brand | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Local 2026 | Tier 4 - Higher Cost Brand | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 4 - Higher Cost Brand | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Advantage 2026 | Tier 4 - Higher Cost Brand | ✓ | — | ✓ Restricted Access | PA | QL |
Medicare Part D
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| HealthSpring True Choice (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring Preferred (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring Preferred Plus (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring Preferred Savings (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring Preferred Select (HMO) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
| HealthSpring TotalCare (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 90 per 30 days | QL |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via oxymorphone hcl |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via oxymorphone hcl |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via oxymorphone hcl |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via oxymorphone hcl tb12 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via oxymorphone hcl tb12 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via oxymorphone hcl tb12 |
Not Covered | — | — | — | None |