posaconazole
Generic: Noxafil
300mg/16.7ml — Suspension
Also known as:
posaconazole oral tablet delayed
posaconazole soln 300mg/16.7ml
posaconazole susp 40mg/ml
posaconazole susp 40 mg/ml
posaconazole tab delayed release 100 mg
Posaconazole 200 Mg/5 Ml Oral Suspension
Posaconazole Dr 100 Mg Tablet
posaconazole susp 40mg/ml; tbec 100mg
Posaconazole Oral Tablet Delayed Release
Posaconazole Oral Suspension
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 |
|---|---|---|---|---|---|
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Complete Gold with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Focused Silver with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze with Atrium Health | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Gold | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Silver | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Standard Expanded Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Clear Silver with $0 Insulin Options | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Elite Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Everyday Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
AmeriHealth Caritas NC
17 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | ✓ | — | — | PA |
| BCBS Federal Focus 2026 | Tier 1 - Generic | ✓ | — | — | PA |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Value 2026
via Noxafil |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Advantage 2026
via Noxafil |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Noxafil |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Local 2026
via Noxafil |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | — Restricted Access | PA |
|
BCBSNC Blue Care 2026
via Noxafil |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | — Restricted Access | PA |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Silver RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
Medicare Part D
92 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
| Senior Care (HMO I-SNP) | Tier 2 - Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 2 - Generic | ✓ | — | ✓ 630 per 30 days | PA | QL |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Erickson Advantage Liberty (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Erickson Advantage Freedom (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Erickson Advantage Signature (HMO-POS) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 4 - Non-Preferred | — | — | ✓ 600 per 30 days | QL |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Platinum Select (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature Giveback (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Alignment Health AVA (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Platinum (HMO)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health smartHMO (HMO)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Platinum Select (HMO)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health AVA (PPO)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
| HealthTeam Advantage Plan I (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthTeam Advantage Plan II (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Enhanced (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Enhanced (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Enhanced (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature Care (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Prime (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Value Plus (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Dual (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Aetna Medicare Signature (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| DEVOTED CORE 001 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
| Blue Medicare PPO Enhanced (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Blue Medicare Essential Plus (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Blue Medicare Enhanced (HMO-POS) | Tier 5 - Specialty | ✓ | — | — | PA |
| Blue Medicare Choice (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Blue Medicare Essential (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Experience Health Medicare Advantage (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Healthy Blue + Medicare (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Platinum (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health smartHMO (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 630 per 30 days | PA | QL |
NC State Health Plan
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | ✓ | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | ✓ | QL |
| NC State Health Plan - HDHP 2026 | Tier 2 - Non-Preferred Generic | — | — | ✓ | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Noxafil |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Noxafil |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via posaconazole tbec |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via posaconazole tbec |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via posaconazole tbec |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Noxafil |
Not Covered | — | — | — | None |
UnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Bronze Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Gold Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |
| UHC Silver Standard (No Referrals) | Tier 3 - Preferred Brand | — | — | ✓ | QL |