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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.
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via carboplatin |
Tier 1 - Preferred Generic | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via carboplatin |
Tier 1 - Preferred Generic | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via carboplatin |
Tier 1 - Preferred Generic | — | — | — | None |
Oscar Health
108 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Bronze Elite + PCP Saver Plus
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Secure
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic Standard | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic Standard | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Gold Classic Standard | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Chronic Care CKM | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Secure | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Classic 4700 | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Classic | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple PCP Saver | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Chronic Care CKM | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010074
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010075
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus with Adult Dental & Vision | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010076
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010077
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010078
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010079
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010080
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010081
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010082
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010083
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010084
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010085
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Elite + PCP Saver Plus with Adult Dental & Vision
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Core Plan
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Core Plan | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes with Adult Dental & Vision
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010108
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010109
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010110
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010111
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010112
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010113
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010114
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010115
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010116
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
69803NC0010117
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Bronze Simple Diabetes with Adult Dental & Vision | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
|
Silver Simple Diabetes with Adult Dental & Vision | with Atrium Health
via carboplatin |
Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 2 - Generic | — | — | — | None |
| Silver Classic | Tier 2 - Generic | — | — | — | None |
| Secure | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | Tier 2 - Generic | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Secure | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| 69803NC0010074 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010075 | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus with Adult Dental & Vision | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| 69803NC0010076 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010077 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010078 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010079 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010080 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010081 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010082 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010083 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010084 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010085 | Tier 2 - Generic | — | — | — | None |
| Bronze Elite + PCP Saver Plus with Adult Dental & Vision | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Diabetes | Tier 2 - Generic | — | — | — | None |
| Silver Core Plan | Tier 2 - Generic | — | — | — | None |
| Silver Core Plan | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes with Adult Dental & Vision | Tier 2 - Generic | — | — | — | None |
| 69803NC0010108 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010109 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010110 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010111 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010112 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010113 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010114 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010115 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010116 | Tier 2 - Generic | — | — | — | None |
| 69803NC0010117 | Tier 2 - Generic | — | — | — | None |
| Bronze Simple Diabetes with Adult Dental & Vision | with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Silver Simple Diabetes with Adult Dental & Vision | with Atrium Health | Tier 2 - Generic | — | — | — | None |