Tolectin

Generic: tolmetin

Tablet

Nsaids

Also known as: tolmetin
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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: 20 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Everyday Bronze with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Gold + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Complete Gold
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Complete Gold
via tolmetin 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via tolmetin 		Tier 2 - Generic — — — None
Everyday Bronze
via tolmetin 		Tier 2 - Generic — — — None
Elite Bronze
via tolmetin 		Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options
via tolmetin 		Tier 2 - Generic — — — None
Standard Expanded Bronze
via tolmetin 		Tier 2 - Generic — — — None
Standard Silver
via tolmetin 		Tier 2 - Generic — — — None
Standard Gold
via tolmetin 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health
via tolmetin 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Expanded Bronze + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Silver + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Gold + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health + Vision + Adult Dental
via tolmetin 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Tolectin 600 		Tier 2 - Generic — — — None
Everyday Bronze
via Tolectin 600 		Tier 2 - Generic — — — None
Elite Bronze
via Tolectin 600 		Tier 2 - Generic — — — None
Clear Silver with $0 Insulin Options
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Expanded Bronze
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Silver
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Gold
via Tolectin 600 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Expanded Bronze with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Silver with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Gold with Atrium Health
via Tolectin 600 		Tier 2 - Generic — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Complete Gold + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Everyday Bronze + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Elite Bronze + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Expanded Bronze + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Standard Silver + Vision + Adult Dental
via Tolectin 600 		Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Tolectin 600 		Tier 1 - Generic — — — None
BCBS Federal Standard Option 2026
via Tolectin 600 		Tier 1 - Generic — — — None
BCBS Federal Basic Option 2026
via Tolectin 600 		Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 20 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via tolmetin 		Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via Tolectin 600 		Tier 1 - Preferred Generic — — — None
NC State Health Plan - HDHP 2026
via Tolectin 600 		Tier 1 - Preferred Generic — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Tolectin 600 		Tier 1 - Preferred Generic — — — None
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