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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.
AmeriHealth Caritas NC
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Noxafil |
Tier 4 - Non-Preferred | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
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 |
|
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 |
Medicare Part D
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Noxafil |
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 AVA (PPO)
via Noxafil |
Tier 5 - Specialty | ✓ | — | — | PA |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Noxafil |
Not Covered | — | — | — | None |
|
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 |