Premphase
Generic: conj est 0.625(14)/ conj est-medroxypro ac
5 MG — Tablet
Also known as:
PREMPHASE TAB
Premphase Oral Tablet
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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
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 4 - Non-Preferred | — | — | — | None |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Standard Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 3 - High Cost Brand | — | — | — | None |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |