Tetracaine Hydrochloride
Generic: tetracaine hcl ophth
5% — Solution
Also known as:
TETRACAINE HYDROCHLORIDE SOLN .5%
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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.
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via tetracaine hcl ophth |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via tetracaine hcl ophth |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via tetracaine hcl ophth |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via tetracaine hcl ophth |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via tetracaine hcl ophth |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Tetracaine Hcl |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Tetracaine Hcl |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Tetracaine Hcl |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Tetracaine Hcl |
Tier 4 - Higher Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Tetracaine Hcl |
Tier 4 - Higher Cost Brand | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Tetracaine Hcl |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Tetracaine Hcl |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Tetracaine Hcl |
Tier 3 - Non-Preferred Brand | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 3 - Non-Preferred Brand | — | — | — | None |