Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | ✓ | — | ST |
TRICARE
1 planUnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Standard (No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Standard (No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Gold Standard (No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |
|
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Solosec |
Tier 4 - Non-Preferred | — | — | ✓ | QL |