stannous fluoride
6.3 MG
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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.
Ambetter (Centene)
68 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Complete Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver $0 Rx Options | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Expanded Bronze | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Silver | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Gold | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Focused Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Expanded Bronze with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Gold with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Elite 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 |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Silver + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Gold + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 0 - $0 Preventive | — | — | — | None |
| Streamlined Silver with Atrium Health | Tier 0 - $0 Preventive | — | — | — | None |
| Streamlined Silver | Tier 0 - $0 Preventive | — | — | — | None |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Expanded Bronze
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Silver
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Gold
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Focused Silver with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Silver with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Gold with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Expanded Bronze + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Silver + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Gold + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Silver with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Signature Gold with Atrium Health + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Streamlined Silver with Atrium Health
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Streamlined Silver
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
|
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Perio Med |
Tier 0 - $0 Preventive | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Easygel |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Easygel |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Easygel |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Easygel |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Easygel |
Tier 4 - Higher Cost Brand | — | — | — | None |