Sulfacetamide Sodium/ Pred

Generic: sulfacetamide sodium- prednisolone ophth

OPHTHALMIC AGENTS

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 13 hours, 20 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Local 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Care 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Value 2026 Tier 4 - Higher Cost Brand None
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