Symproic

Generic: naldemedine

0.2 MG — Tablet

URINARY ANTISPASMODICS

Also known as: naldemedine SYMPROIC TABS .2MG Symproic Oral Tablet
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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.
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 3 - Preferred Brand — ✓ ✓ ST | QL
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 3 - Preferred Brand — ✓ ✓ ST | QL
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 3 - Preferred Brand — ✓ ✓ ST | QL
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Silver Premier + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Brand-Preferred — ✓ ✓ ST | QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand ✓ — — PA
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Local 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Care 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Value 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Advantage 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic — — ✓ 30 per 30 days QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 11 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Tier 2 - Non-Preferred Generic ✓ — — PA
NC State Health Plan - HDHP 2026 Tier 2 - Non-Preferred Generic ✓ — — PA
NC State Health Plan - 80/20 Plus PPO 2026 Tier 2 - Non-Preferred Generic ✓ — — PA
Source: PDF  ·  Formulary date: Sep 23, 2026  ·  Checked: 11 hours, 21 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Standard (HSA, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) Tier 3 - Preferred Brand ✓ — ✓ PA | QL
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