St. Joseph Aspirin

Generic: aspirin

81 MG — Chewable Tablet

Platelet Aggregation Inhibitor

Also known as: aspirin

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Elite Bronze Tier 0 - $0 Preventive None
Everyday Bronze Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 0 - $0 Preventive None
Complete Gold Tier 0 - $0 Preventive None
Standard Gold + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Silver + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Expanded Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Expanded 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
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold
via Bayer Aspirin
Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Bayer Aspirin
Tier 0 - $0 Preventive None
Everyday Bronze
via Bayer Aspirin
Tier 0 - $0 Preventive None
Elite Bronze
via Bayer Aspirin
Tier 0 - $0 Preventive None
Clear Silver with $0 Insulin Options
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Expanded Bronze
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Silver
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Gold
via Bayer Aspirin
Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Elite Bronze with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Focused Silver with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Complete Gold with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Expanded Bronze with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Silver with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Gold with Atrium Health
via Bayer Aspirin
Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Complete Gold + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Everyday Bronze + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Elite Bronze + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Elite Bronze with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Focused Silver with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Complete Gold with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Expanded Bronze + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Silver + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Gold + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Silver with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Standard Gold with Atrium Health + Vision + Adult Dental
via Bayer Aspirin
Tier 0 - $0 Preventive None
Elite Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Everyday Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold + Vision + Adult Dental Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Gold with Atrium Health Tier 0 - $0 Preventive None
Standard Silver with Atrium Health Tier 0 - $0 Preventive None
Standard Expanded Bronze with Atrium Health Tier 0 - $0 Preventive None
Complete Gold with Atrium Health Tier 0 - $0 Preventive None
Focused Silver with Atrium Health Tier 0 - $0 Preventive None
Elite Bronze with Atrium Health Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health Tier 0 - $0 Preventive None
Standard Gold Tier 0 - $0 Preventive None
Standard Silver Tier 0 - $0 Preventive None
Standard Expanded Bronze Tier 0 - $0 Preventive None
Clear Silver with $0 Insulin Options Tier 0 - $0 Preventive None
Standard Gold
via Ecotrin
Tier 1 - Preferred Generic None
Standard Gold + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Standard Silver + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Standard Expanded Bronze + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Complete Gold
via Ecotrin
Tier 1 - Preferred Generic None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Ecotrin
Tier 1 - Preferred Generic None
Everyday Bronze
via Ecotrin
Tier 1 - Preferred Generic None
Elite Bronze
via Ecotrin
Tier 1 - Preferred Generic None
Clear Silver with $0 Insulin Options
via Ecotrin
Tier 1 - Preferred Generic None
Standard Expanded Bronze
via Ecotrin
Tier 1 - Preferred Generic None
Standard Silver
via Ecotrin
Tier 1 - Preferred Generic None
Everyday Bronze with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Elite Bronze with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Standard Gold with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Complete Gold + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Everyday Bronze + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Elite Bronze + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Elite Bronze with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Focused Silver with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Complete Gold with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Standard Silver with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Standard Gold with Atrium Health + Vision + Adult Dental
via Ecotrin
Tier 1 - Preferred Generic None
Focused Silver with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Complete Gold with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Standard Expanded Bronze with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Standard Silver with Atrium Health
via Ecotrin
Tier 1 - Preferred Generic None
Standard Gold
via Ascomp
Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health
via aspirin
Tier 2 - Generic QL
Complete Gold with Atrium Health
via aspirin
Tier 2 - Generic QL
Standard Expanded Bronze
via Ascomp
Tier 2 - Generic QL
Clear Silver with $0 Insulin Options
via Ascomp
Tier 2 - Generic QL
Elite Bronze
via Ascomp
Tier 2 - Generic QL
Everyday Bronze
via Ascomp
Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Ascomp
Tier 2 - Generic QL
Standard Silver
via Ascomp
Tier 2 - Generic QL
Everyday Bronze with Atrium Health
via Ascomp
Tier 2 - Generic QL
Elite Bronze with Atrium Health
via Ascomp
Tier 2 - Generic QL
Focused Silver with Atrium Health
via Ascomp
Tier 2 - Generic QL
Complete Gold with Atrium Health
via Ascomp
Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health
via Ascomp
Tier 2 - Generic QL
Standard Silver with Atrium Health
via Ascomp
Tier 2 - Generic QL
Standard Gold with Atrium Health
via Ascomp
Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Complete Gold + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Everyday Bronze + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Elite Bronze + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Complete Gold
via aspirin
Tier 2 - Generic QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Standard Expanded Bronze + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Standard Silver + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Standard Gold + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Focused Silver with Atrium Health
via aspirin
Tier 2 - Generic QL
Elite Bronze with Atrium Health
via aspirin
Tier 2 - Generic QL
Everyday Bronze with Atrium Health
via aspirin
Tier 2 - Generic QL
Standard Gold
via aspirin
Tier 2 - Generic QL
Standard Silver
via aspirin
Tier 2 - Generic QL
Standard Expanded Bronze
via aspirin
Tier 2 - Generic QL
Clear Silver with $0 Insulin Options
via aspirin
Tier 2 - Generic QL
Elite Bronze
via aspirin
Tier 2 - Generic QL
Everyday Bronze
via aspirin
Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via aspirin
Tier 2 - Generic QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Ascomp
Tier 2 - Generic QL
Complete Gold
via Ascomp
Tier 2 - Generic QL
Standard Gold with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Silver with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Gold + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Silver + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Expanded Bronze + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Complete Gold with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Focused Silver with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Elite Bronze + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Everyday Bronze + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Complete Gold + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via aspirin
Tier 2 - Generic QL
Standard Gold with Atrium Health
via aspirin
Tier 2 - Generic QL
Standard Silver with Atrium Health
via aspirin
Tier 2 - Generic QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026
via aspirin
Tier A - ACA $0 Copay None
BCBSNC Blue Care 2026
via aspirin
Tier A - ACA $0 Copay None
BCBSNC Blue Advantage 2026
via aspirin
Tier A - ACA $0 Copay None
BCBSNC Blue Home with UNC Health Alliance 2026
via aspirin
Tier A - ACA $0 Copay None
BCBSNC Blue Local 2026
via aspirin
Tier A - ACA $0 Copay None
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic None
NHC Advantage (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic 60 per 30 days QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic 60 per 30 days QL
PruittHealth Premier (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic 60 per 30 days QL
Liberty Medicare Dual Plan (HMO D-SNP)
via aspirin
Tier 1 - Preferred Generic 60 per 30 days QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic None
Provider Partners North Carolina Community Plan (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic None
Longevity Health Plan (HMO I-SNP)
via aspirin
Tier 1 - Preferred Generic None
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via aspirin
Tier 2 - Generic PA
AmeriHealth Caritas VIP Care (HMO D-SNP)
via aspirin
Tier 2 - Generic PA
Senior Care (HMO I-SNP)
via aspirin
Tier 2 - Generic 60 per 30 days QL
Liberty Medicare Advantage (HMO C-SNP)
via aspirin
Tier 2 - Generic 60 per 30 days QL
Wellcare Simple Open (PPO)
via aspirin
Tier 2 - Generic None
Wellcare Simple (HMO-POS)
via aspirin
Tier 2 - Generic None
Wellcare Giveback Open (PPO)
via aspirin
Tier 2 - Generic None
Troy Medicare (HMO)
via aspirin
Tier 2 - Generic PA
Erickson Advantage Guardian (HMO-POS I-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Dual Complete NC-S001 (PPO D-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Dual Complete NC-S2 (PPO D-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0001 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0004 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0016 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0017 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0019 (PPO)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
Erickson Advantage Signature (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
Erickson Advantage Freedom (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
Erickson Advantage Liberty (HMO-POS)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Complete Care NC-25 (HMO-POS C-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Complete Care NC-27 (HMO-POS C-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
UHC Complete Care NC-28 (HMO-POS C-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
Erickson Advantage Champion (HMO-POS C-SNP)
via aspirin
Tier 3 - Preferred Brand 60 per 30 days QL
Alignment Health Platinum (HMO)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health smartHMO (HMO)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Platinum Select (HMO)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health AVA (PPO)
via Ascomp
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Platinum (HMO)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health smartHMO (HMO)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Platinum Select (HMO)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Alignment Health AVA (PPO)
via aspirin
Tier 3 - Preferred Brand 180 per 30 days QL
Aetna Medicare Signature (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Wellcare Dual Reserve (HMO-POS D-SNP)
via aspirin
Tier 4 - Non-Preferred None
Wellcare Dual Access (HMO-POS D-SNP)
via aspirin
Tier 4 - Non-Preferred None
Wellcare Assist Open (PPO)
via aspirin
Tier 4 - Non-Preferred None
Wellcare Dual Liberty Open (PPO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
HealthTeam Advantage Vitality Plan (PPO)
via aspirin
Tier 4 - Non-Preferred None
HealthTeam Advantage Plan II (PPO)
via aspirin
Tier 4 - Non-Preferred None
HealthTeam Advantage Plan I (PPO)
via aspirin
Tier 4 - Non-Preferred None
Healthy Blue + Medicare (HMO-POS D-SNP)
via aspirin
Tier 4 - Non-Preferred None
Experience Health Medicare Advantage (HMO)
via aspirin
Tier 4 - Non-Preferred None
Blue Medicare Essential (HMO)
via aspirin
Tier 4 - Non-Preferred None
Blue Medicare Choice (HMO)
via aspirin
Tier 4 - Non-Preferred None
Blue Medicare Enhanced (HMO-POS)
via aspirin
Tier 4 - Non-Preferred None
Blue Medicare Essential Plus (HMO-POS)
via aspirin
Tier 4 - Non-Preferred None
Blue Medicare PPO Enhanced (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE 008 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE 005 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE 003 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CHOICE 001 NC (PPO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED GIVEBACK 012 NC (HMO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED GIVEBACK 002 NC (HMO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED CORE 001 NC (HMO)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED DUAL 009 NC (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
Aetna Medicare Full Dual Care (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature Care (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Prime (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Value Plus (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Dual (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred None
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring Preferred Plus (HMO)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring Preferred Savings (HMO)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring Preferred Select (HMO)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring Preferred (HMO)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring TotalCare Plus (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring TotalCare (HMO D-SNP)
via aspirin
Tier 4 - Non-Preferred None
HealthSpring True Choice (PPO)
via aspirin
Tier 4 - Non-Preferred None
Aetna Medicare Chronic Care Value (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Chronic Care (HMO C-SNP)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature Giveback (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Wellcare Dual Liberty (HMO-POS D-SNP)
via aspirin
Tier 4 - Non-Preferred None
Aetna Medicare Signature Extra (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Enhanced (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Enhanced (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Signature (PPO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Aetna Medicare Enhanced (HMO)
via aspirin
Tier 4 - Non-Preferred 60 per 30 days QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Ascomp
Non-Preferred PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via Yosprala
Not Covered None
NC State Health Plan - 80/20 Plus PPO 2026
via Yosprala
Not Covered None
NC State Health Plan - HDHP 2026
via Yosprala
Not Covered None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via aspirin
Tier 3 - Non-Formulary None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 19 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
via Yosprala
Unknown QL
UnitedHealthcare NC Individual & Family 2026
via aspirin
Unknown None
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