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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Epclusa |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Epclusa |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Epclusa |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Care 2026
via Epclusa |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Value 2026
via Epclusa |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Advantage 2026
via Sofosbuvir/Velpatasvir |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Sofosbuvir/Velpatasvir |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Local 2026
via Sofosbuvir/Velpatasvir |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Care 2026
via Sofosbuvir/Velpatasvir |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Value 2026
via Sofosbuvir/Velpatasvir |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Advantage 2026
via Epclusa |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Epclusa |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
|
BCBSNC Blue Local 2026
via Epclusa |
Tier 3 - High Cost Brand | ✓ | — | — | PA |
Medicare Part D
69 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H6622-057 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H6622-060 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H6622-061 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Choice H8145-004 (PFFS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Aetna Medicare Signature (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Dual (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Value Plus (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Prime (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature Care (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Enhanced (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Enhanced (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Enhanced (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature Extra (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature Giveback (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Signature (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring True Choice (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring TotalCare (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Select (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Savings (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HealthSpring Preferred Plus (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CORE 001 NC (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED GIVEBACK 002 NC (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED GIVEBACK 012 NC (HMO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE 001 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE 003 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE 005 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE 008 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Humana Gold Plus H1036-137 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H1036-233 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Dual Select H1036-307 (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H1036-335 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice Giveback H5216-017 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice H5216-211 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Full Access H5525-034 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice Giveback H5525-035 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice H5525-049 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice H5525-050 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice H5525-070 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Dual Select H5525-072 (PPO D-SNP)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
HumanaChoice H5525-083 (PPO)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H6622-025 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
|
Humana Gold Plus H6622-026 (HMO-POS)
via Epclusa |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 28 days | PA | QL |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Epclusa |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Epclusa |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |
|
NC State Health Plan - HDHP 2026
via Epclusa |
Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ For genotypes | PA | QL |