pnv-dha

Generic: multivitamin combination no.47/ferrous fum/folate no.1/dha

Capsule

Also known as: pnv-dha cap PNV-DHA CAP DOCUSATE Pnv-Dha Cap

Coverage by Insurer

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

Cigna

40 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 14 hours, 22 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Connect Silver 3500 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect myDiabetesCare Silver via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect myDiabetesCare Bronze via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Zatean-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect myDiabetesCare Silver via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect myDiabetesCare Bronze via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Wescap-Pn Dha	Tier 1 - Preferred Generic	—	—	—	None
Connect Gold CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Gold RD CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Bronze CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Silver CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Silver RD CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Bronze RD CMS Standard via Zatean-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Silver CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Silver RD CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Gold CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Bronze RD CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Gold RD CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None
Connect Bronze CMS Standard via Wescap-Pn Dha	Tier 2 - Generic	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 14 hours, 22 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 70/30 Standard PPO 2026	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026	Not Covered	—	—	—	None

TRICARE

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 14 hours, 22 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via multivitamin combination no.47/ferrous fum/folate no.1/dha	Tier 3 - Non-Formulary	—	—	—	None