Quazepam

15 Mg — Tablet

Benzodiazepines

Also known as: Doral quazepam tabs 15mg Quazepam 15 Mg Tablet Quazepam 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.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze Tier 4 - Non-Preferred ✓ — — PA
Signature Silver Tier 4 - Non-Preferred ✓ — — PA
Signature Gold Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Silver + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Gold + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options Tier 4 - Non-Preferred ✓ — — PA
Complete Gold Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Streamlined Silver Tier 4 - Non-Preferred ✓ — — PA
Streamlined Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze Tier 4 - Non-Preferred ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — ✓ QL
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred — — ✓ QL
Source: PDF  ·  Formulary date: Oct 7, 2026  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect myDiabetesCare Silver Tier 4 - Non-Preferred ✓ — — PA
Connect Gold 1500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Gold RD CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 5000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3600 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Silver CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect Gold CMS Standard Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Bronze Tier 4 - Non-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Doral 		Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered — — — None
NC State Health Plan - HDHP 2026 Not Covered — — — None
Source: CMS QHP JSON  ·  Checked: 15 hours ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Simple PCP Saver Tier 3 - Preferred Brand — ✓ — ST
Gold Elite Saver Plus Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Diabetes Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic Standard Tier 3 - Preferred Brand — ✓ — ST
Silver Classic Standard Tier 3 - Preferred Brand — ✓ — ST
Gold Classic Standard Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic Standard | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Classic Standard | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Gold Classic Standard | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Classic Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Chronic Care CKM | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Secure | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic 4700 | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Classic | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Diabetes | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Simple PCP Saver | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Gold Elite Saver Plus | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Diabetes | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Chronic Care CKM | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
AIAN Cost Share Tier 3 - Preferred Brand — ✓ — ST
AIAN Cost Share | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Bronze Elite + PCP Saver Plus Tier 3 - Preferred Brand — ✓ — ST
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 3 - Preferred Brand — ✓ — ST
Secure Tier 3 - Preferred Brand — ✓ — ST
Bronze Classic 4700 Tier 3 - Preferred Brand — ✓ — ST
Source: PDF  ·  Formulary date: Sep 23, 2026  ·  Checked: 14 hours, 59 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Bronze Standard (HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — — None
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