propranolol hcl
10 mg, 20 mg, 40 mg, 60 mg, 80 mg — Capsule
Also known as:
propranolol hcl oral
propranolol hcl soln 1mg/ml
propranolol hcl cap er 24hr 60 mg, 80 mg, 120 mg, 160 mg
propranolol hcl tab 10 mg, 20 mg, 40 mg, 60 mg, 80 mg
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 |
|---|---|---|---|---|---|
|
Standard Expanded Bronze with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Silver with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Silver
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Expanded Bronze
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Gold + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Silver + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Gold with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Gold
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Expanded Bronze + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield of NC
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Inderal La |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Inderal La |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Local 2026
via Inderal La |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Care 2026
via Inderal La |
Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Value 2026
via Inderal La |
Tier 1 - Lowest Cost Generic | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 1 - Lowest Cost Generic | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via propranolol hydrochloride |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via propranolol hydrochloride |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via propranolol hydrochloride |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via propranolol hydrochloride |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via propranolol hydrochloride |
Tier 4 - Higher Cost Brand | — | — | — | None |
Medicare Part D
140 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Troy Medicare (HMO)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Longevity Health Plan (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Community Plan (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
PruittHealth Premier (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
NHC Advantage (HMO I-SNP)
via propranolol hydrochloride |
Tier 1 - Preferred Generic | — | — | — | None |
|
Wellcare Simple (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Giveback Open (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Blue Medicare PPO Enhanced (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Blue Medicare Essential Plus (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Blue Medicare Enhanced (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Blue Medicare Choice (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Blue Medicare Essential (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Experience Health Medicare Advantage (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health Platinum (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health smartHMO (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health Platinum Select (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Alignment Health AVA (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthTeam Advantage Plan I (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthTeam Advantage Plan II (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthTeam Advantage Vitality Plan (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Dual Liberty Open (PPO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Assist Open (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Dual Access (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Dual Liberty (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Complete Care NC-28 (HMO-POS C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Erickson Advantage Signature (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Erickson Advantage Freedom (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Erickson Advantage Liberty (HMO-POS)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Complete Care NC-25 (HMO-POS C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
UHC Complete Care NC-27 (HMO-POS C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Erickson Advantage Champion (HMO-POS C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Dual (HMO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Value Plus (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Prime (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature Care (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Enhanced (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Enhanced (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature Extra (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature Giveback (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Signature (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring True Choice (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring TotalCare (HMO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring Preferred (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring Preferred Select (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring Preferred Savings (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
HealthSpring Preferred Plus (HMO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Liberty Medicare Advantage (HMO C-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Simple Open (PPO)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
Senior Care (HMO I-SNP)
via propranolol hydrochloride |
Tier 2 - Generic | — | — | — | None |
|
DEVOTED CORE 001 NC (HMO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 008 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-137 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-233 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Dual Select H1036-307 (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-335 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice Giveback H5216-017 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5216-211 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Full Access H5525-034 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice Giveback H5525-035 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-049 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-050 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-070 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Dual Select H5525-072 (PPO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-083 (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-025 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-026 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-057 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-060 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-061 (HMO-POS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Choice H8145-004 (PFFS)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 005 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 003 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 001 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED GIVEBACK 012 NC (HMO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED GIVEBACK 002 NC (HMO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via propranolol hydrochloride |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via propranolol hydrochloride |
Tier 6 - Specialty Plus | — | — | — | None |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |