Relexxii

Generic: methylphenidate hcl

18MG, 27MG, 36MG, 54MG — Extended Release Tablet

Also known as: RELEXXII TBCR 18MG, 27MG, 36MG, 54MG

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Basic Option 2026	Tier 3 - Non-Preferred Brand	✓	—	—	PA
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	✓	—	—	PA

15 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 via Metadate Cd	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Local 2026 via Metadate Cd	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Care 2026 via Metadate Cd	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Value 2026 via Metadate Cd	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Advantage 2026 via methylphenidate hcl	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026 via methylphenidate hcl	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Local 2026 via methylphenidate hcl	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Care 2026 via methylphenidate hcl	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Value 2026 via methylphenidate hcl	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Advantage 2026 via Metadate Cd	Tier 2 - Medium Cost Generic/Brand	—	—	✓	QL
BCBSNC Blue Advantage 2026 via Methylphenidate Hydrochlo	Tier 4 - Higher Cost Brand	—	—	✓	QL
BCBSNC Blue Local 2026 via Methylphenidate Hydrochlo	Tier 4 - Higher Cost Brand	—	—	✓	QL
BCBSNC Blue Care 2026 via Methylphenidate Hydrochlo	Tier 4 - Higher Cost Brand	—	—	✓	QL
BCBSNC Blue Value 2026 via Methylphenidate Hydrochlo	Tier 4 - Higher Cost Brand	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026 via Methylphenidate Hydrochlo	Tier 4 - Higher Cost Brand	—	—	✓	QL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via methylphenidate hcl	Tier 1 - Basic Core Formulary	✓	—	—	PA

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via methylphenidate hcl	Unknown	✓	—	✓	PA \| QL