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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.
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Rotarix |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Rotarix |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Local 2026
via Rotarix |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Care 2026
via Rotarix |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Value 2026
via Rotarix |
Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier A - ACA $0 Copay | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Rotarix |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Rotarix |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Rotarix |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
UnitedHealthcare
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UnitedHealthcare NC Individual & Family 2026 | Tier 1 - $0 Copay Preventive | — | — | — months of age or younger . QL; $0 Copay for members 19 | None |
|
UnitedHealthcare NC Individual & Family 2026
via Rotarix |
Tier 1 - $0 Copay Preventive | — | — | — months of age or younger . QL; $0 copay for members 8 | None |