Serevent Diskus

Generic: salmeterol xinafoate

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

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 18 minutes ago

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 18 minutes ago

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

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 17 hours, 18 minutes ago

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