pitavastatin calcium
Generic: Livalo
1 mg, 2 mg, 4 mg — Tablet
Also known as:
pitavastatin calcium tabs 1mg, 2mg, 4mg
LIVALO
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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.
Blue Cross Blue Shield Federal
4 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via Livalo |
Tier 3 - Non-Preferred Brand | — | — | — | None |
Medicare Part D
74 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE 008 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE 005 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring True Choice (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring TotalCare (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring Preferred (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring Preferred Select (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring Preferred Savings (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| HealthSpring Preferred Plus (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CORE 001 NC (HMO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE 001 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE 003 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 1 - Preferred Generic | — | ✓ | ✓ 30 per 30 days | ST | QL |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
UHC Complete Care NC-27 (HMO-POS C-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
Erickson Advantage Signature (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
Erickson Advantage Freedom (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
Erickson Advantage Liberty (HMO-POS)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Complete Care NC-25 (HMO-POS C-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
UHC Complete Care NC-28 (HMO-POS C-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
|
Erickson Advantage Champion (HMO-POS C-SNP)
via Livalo |
Tier 3 - Preferred Brand | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Simple Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Simple (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| Wellcare Giveback Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| HealthTeam Advantage Plan I (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HealthTeam Advantage Plan II (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Wellcare Assist Open (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 30 per 30 days | QL |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 6 - Specialty Plus | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 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 - 80/20 Plus PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Livalo |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Livalo |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Livalo |
Not Covered | — | — | — | None |