Peg-Prep

Generic: bisacodyl

Kit

Also known as: PEG-PREP KIT Peg-Prep Kit

Coverage by Insurer

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

Ambetter (Centene)

87 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 20 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Complete Gold + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Clear Silver with $0 Insulin Options via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Clear Silver with $0 Insulin Options via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health + Vision + Adult Dental via Dulcolax	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health + Vision + Adult Dental via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Clear Silver with $0 Insulin Options via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Everyday Bronze with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Elite Bronze with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Focused Silver with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Complete Gold with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Silver with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Standard Gold with Atrium Health + Vision + Adult Dental via bisacodyl	Tier 1 - Preferred Generic	—	—	—	None
Enhanced Asthma/COPD Care Silver with $0 Drug Options via The Magic Bullet	Tier 1 - Preferred Generic	—	—	—	None

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 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
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 4 - Higher Cost Brand	—	—	—	None

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 20 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - HDHP 2026	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None