salmeterol xinafoate

50 mcg — Inhaler

Also known as: SEREVENT DISKUS

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

5 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 23 hours, 3 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026 via Serevent Diskus	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Advantage 2026 via Serevent Diskus	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026 via Serevent Diskus	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Local 2026 via Serevent Diskus	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Care 2026 via Serevent Diskus	Tier 3 - High Cost Brand	—	—	✓	QL

Cigna

20 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 23 hours, 3 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Connect Bronze CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze RD CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Gold RD CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect myDiabetesCare Silver via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver RD 2200 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Gold 1500 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect myDiabetesCare Bronze via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze 5500 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze RD 6000 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver 3500 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze RD 5000 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver RD 3500 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze 7000 HSA Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver 4400 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver RD 5000 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver 3000 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Bronze 6500 Indiv Med Deductible via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Silver RD CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL
Connect Gold CMS Standard via Serevent Diskus	Tier 4 - Non-Preferred	—	✓	✓	ST \| QL

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 23 hours, 3 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Serevent Diskus	Preferred	—	—	—	None

TRICARE

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 23 hours, 3 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 1 - Basic Core Formulary	—	—	✓	QL