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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.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Fareston |
Tier 5 - Specialty | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Fareston |
Tier 5 - Specialty | — | — | — | None |
|
BCBSNC Blue Local 2026
via Fareston |
Tier 5 - Specialty | — | — | — | None |
|
BCBSNC Blue Care 2026
via Fareston |
Tier 5 - Specialty | — | — | — | None |
|
BCBSNC Blue Value 2026
via Fareston |
Tier 5 - Specialty | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze 5500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver 4400 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver 3000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze 6500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver RD CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Gold CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze RD CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Gold RD CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Bronze CMS Standard | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Gold 1500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect myDiabetesCare Silver | Tier 4 - Non-Preferred | — | — | ✓ | QL |
| Connect myDiabetesCare Bronze | Tier 4 - Non-Preferred | — | — | ✓ | QL |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fareston |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fareston |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fareston |
Tier 3 - Non-Preferred Brand | — | — | — | None |