Temodar

Generic: temozolomide

100 MG

Alkylating Drug

Also known as: temozolomide
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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: Jan 1, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold with Atrium Health + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Streamlined Silver with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Streamlined Silver
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via temozolomide 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold Tier 5 - Specialty — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options Tier 5 - Specialty — — ✓ QL
Everyday Bronze Tier 5 - Specialty — — ✓ QL
Elite Bronze Tier 5 - Specialty — — ✓ QL
Clear Silver with $0 Insulin Options Tier 5 - Specialty — — ✓ QL
Signature Expanded Bronze Tier 5 - Specialty — — ✓ QL
Signature Silver Tier 5 - Specialty — — ✓ QL
Signature Gold Tier 5 - Specialty — — ✓ QL
Everyday Bronze with Atrium Health Tier 5 - Specialty — — ✓ QL
Elite Bronze with Atrium Health Tier 5 - Specialty — — ✓ QL
Focused Silver with Atrium Health Tier 5 - Specialty — — ✓ QL
Complete Gold with Atrium Health Tier 5 - Specialty — — ✓ QL
Signature Expanded Bronze with Atrium Health Tier 5 - Specialty — — ✓ QL
Signature Silver with Atrium Health Tier 5 - Specialty — — ✓ QL
Signature Gold with Atrium Health Tier 5 - Specialty — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Complete Gold + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Everyday Bronze + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Elite Bronze + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Silver + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Gold + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Signature Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options Tier 5 - Specialty — — ✓ QL
Streamlined Silver with Atrium Health Tier 5 - Specialty — — ✓ QL
Streamlined Silver Tier 5 - Specialty — — ✓ QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental Tier 5 - Specialty — — ✓ QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via temozolomide 		Tier 2 - Preferred Brand — — — None
BCBS Federal Basic Option 2026
via temozolomide 		Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Standard Option 2026
via temozolomide 		Tier 4 - Preferred Specialty — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026
via temozolomide 		Tier 2 - Medium Cost Generic/Brand ✓ — — PA
BCBSNC Blue Advantage 2026
via temozolomide 		Tier 2 - Medium Cost Generic/Brand ✓ — — PA
BCBSNC Blue Value 2026
via temozolomide 		Tier 2 - Medium Cost Generic/Brand ✓ — — PA
BCBSNC Blue Home with UNC Health Alliance 2026
via temozolomide 		Tier 2 - Medium Cost Generic/Brand ✓ — — PA
BCBSNC Blue Local 2026
via temozolomide 		Tier 2 - Medium Cost Generic/Brand ✓ — — PA
Source: PDF  ·  Formulary date: Oct 7, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Gold RD CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver RD 2200 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver RD CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver RD 5000 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver RD 3500 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze RD CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect myDiabetesCare Bronze
via temozolomide 		Tier 5 - Specialty — — — None
Connect myDiabetesCare Silver
via temozolomide 		Tier 5 - Specialty — — — None
Connect Gold 1500 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze 6500 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze 5500 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver 5000 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver 3600 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver 3000 Indiv Med Deductible
via temozolomide 		Tier 5 - Specialty — — — None
Connect Bronze CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Connect Silver CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Connect Gold CMS Standard
via temozolomide 		Tier 5 - Specialty — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026
via temozolomide 		Tier 4 - Specialty Generic ✓ — — PA
NC State Health Plan - 70/30 Standard PPO 2026
via temozolomide 		Tier 4 - Specialty Generic ✓ — — PA
NC State Health Plan - 80/20 Plus PPO 2026
via temozolomide 		Tier 4 - Specialty Generic ✓ — — PA
Source: CMS QHP JSON  ·  Checked: 2 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Simple Chronic Care CKM | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
AIAN Cost Share Tier 5 - Specialty ✓ — — PA
AIAN Cost Share | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus Tier 5 - Specialty ✓ — — PA
Silver Classic Tier 5 - Specialty ✓ — — PA
Secure Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard Tier 5 - Specialty ✓ — — PA
Silver Classic Standard Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health Tier 5 - Specialty ✓ — — PA
Secure | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Classic | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Classic Standard Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Classic
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Secure
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Classic Standard
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Gold Classic Standard
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Classic Standard | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Gold Classic Standard | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Secure | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Classic | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Diabetes | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple Chronic Care CKM | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
AIAN Cost Share
via temozolomide 		Tier 5 - Specialty ✓ — — PA
AIAN Cost Share | with Atrium Health
via temozolomide 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Diabetes | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Sep 23, 2026  ·  Checked: 2 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via temozolomide 		Tier 5 - Specialty — — — None
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