SARS-CoV-2 (COVID-19) vaccine, mRNA-1273 OMICRON (KP.2)
0.025 MG, 0.05 MG — Prefilled Syringe
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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.
Ambetter (Centene)
58 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Focused Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Expanded Bronze
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Silver
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Gold
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Focused Silver with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Expanded Bronze with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Silver with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Gold with Atrium Health
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Expanded Bronze + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Silver + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Gold + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Spikevax 2024-2025 |
Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze | Tier 0 - $0 Preventive | — | — | — | None |
AmeriHealth Caritas NC
17 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Spikevax 2024-2025 |
Tier 3 - Preferred Brand | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Brand-Preferred | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Brand-Preferred | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Silver Simple Diabetes | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| AIAN Cost Share | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Classic Standard | Tier 0 - $0 Preventive | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Classic Standard | Tier 0 - $0 Preventive | — | — | — | None |
| Gold Classic Standard | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Classic | Tier 0 - $0 Preventive | — | — | — | None |
| Secure | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Classic 4700 | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple PCP Saver | Tier 0 - $0 Preventive | — | — | — | None |
| Gold Elite Saver Plus | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Simple Diabetes | Tier 0 - $0 Preventive | — | — | — | None |
| Secure | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |