Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Complete Gold
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver with Atrium Health
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Streamlined Silver
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via beclomethasone dipropionate |
Tier 2 - Generic | — | — | — | None |
NC Medicaid PDL
1 planTRICARE
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
TRICARE Uniform Formulary 2026
via beclomethasone dipropionate |
Tier 3 - Non-Formulary | — | — | ✓ QVAR/REDIHALER TO BE DISP AT MAX QTY OF 1 UNIT PER DISP AT RTL OR 3 UNITS AT MAIL | QL Quantity limit |
|
TRICARE Uniform Formulary 2026
via Qnasl Children |
Tier 3 - Non-Formulary | — | ✓ | ✓ QNASL CHILDRENS 40MCG SPRAY LTD TO A MAX QTY OF 1 UNIT PER DISPENSING AT RETAIL OR 3 UNITS AT MAIL | ST | QL Step therapy: SEL ANTIHISTAMINE/STEROIDS NS PT >4 W/O OR W/O ASTELIN,ATROVENT,FLONASE,FLUNISOLIDE NS IN 180D REQPA; Quantity limit |
| TRICARE Uniform Formulary 2026 | Tier 3 - Non-Formulary | — | ✓ | ✓ QNASL LTD TO A MAX QTY OF 1 CANISTER PER DISPENSING AT RETAIL OR 3 CANISTERS AT MAIL | ST | QL Step therapy: SEL ANTIHISTAMINE/STEROIDS NS PT >4 W/O OR W/O ASTELIN,ATROVENT,FLONASE,FLUNISOLIDE NS IN 180D REQPA; Quantity limit |