sodium fluoride

Generic: sodium fluoride chew

0.55 MG — Chewable Tablet

Also known as: sodium fluoride oral

Coverage by Insurer

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

Ambetter (Centene)

29 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 14 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Enhanced Asthma/COPD Care Silver with $0 Drug Options	Tier 0 - $0 Preventive	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Expanded Bronze + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Silver with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Gold with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Complete Gold	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Gold + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Silver + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Everyday Bronze	Tier 0 - $0 Preventive	—	—	✓	QL
Elite Bronze with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Focused Silver with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Complete Gold with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Expanded Bronze with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Silver with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Gold with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Elite Bronze	Tier 0 - $0 Preventive	—	—	✓	QL
Clear Silver with $0 Insulin Options	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Expanded Bronze	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Silver	Tier 0 - $0 Preventive	—	—	✓	QL
Standard Gold	Tier 0 - $0 Preventive	—	—	✓	QL
Everyday Bronze with Atrium Health	Tier 0 - $0 Preventive	—	—	✓	QL
Complete Gold + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Elite Bronze + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 0 - $0 Preventive	—	—	✓	QL

Blue Cross Blue Shield Federal

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via Dentagel	Tier 1 - Generic	—	—	—	None
BCBS Federal Standard Option 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Generic	—	—	—	None
BCBS Federal Basic Option 2026 via Dentagel	Tier 1 - Generic	—	—	—	None
BCBS Federal Basic Option 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Generic	—	—	—	None
BCBS Federal Focus 2026 via Dentagel	Tier 1 - Generic	—	—	—	None
BCBS Federal Focus 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Generic	—	—	—	None

Blue Cross Blue Shield of NC

60 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026 via Fluorimax 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Just Right 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Just Right 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Just Right 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Just Right 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Just Right 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Sf 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Sf 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Sf 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Sf 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Sf 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Sodium Fluoride 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Sodium Fluoride 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Sodium Fluoride 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Sodium Fluoride 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Sodium Fluoride 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Sodium Fluoride 5000 Ppm	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Fluoride	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Fluoride	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Fluoride	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Fluoride	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Fluoride	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Clinpro 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Clinpro 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Clinpro 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Clinpro 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Clinpro 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Denta 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Denta 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Denta 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Denta 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Denta 5000 Plus	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Dentagel	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Dentagel	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Dentagel	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Dentagel	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Dentagel	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Fluoridex Daily Defense	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Fluoridex Daily Defense	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Fluoridex Daily Defense	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Fluoridex Daily Defense	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Fluoridex Daily Defense	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Fluoridex Enhanced Whiten	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Fluoridex Enhanced Whiten	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Fluoridex Enhanced Whiten	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Fluoridex Enhanced Whiten	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Fluoridex Enhanced Whiten	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Fluorimax 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Fluorimax 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Fluorimax 5000	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Fluorimax 5000	Tier 1 - Lowest Cost Generic	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 14 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026 via sodium fluoride chew	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via sodium fluoride chew	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via sodium fluoride chew	Tier 1 - Preferred Generic	—	—	—	None

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 14 hours, 30 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Tier 1 - $0 Copay Preventive	—	—	— members ages 0 to 16 years .	None