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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
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Value 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Advantage 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Local 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Care 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
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Tier 1 - Preferred Generic | ✓ | ✓ | ✓ | PA | ST | QL |
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
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Tier 1 - Preferred Generic | ✓ | ✓ | ✓ | PA | ST | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
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Tier 1 - Preferred Generic | ✓ | ✓ | ✓ | PA | ST | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
TRICARE
1 planUnitedHealthcare
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UnitedHealthcare NC Individual & Family 2026
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Tier 3 - Mid-Range Cost | ✓ | — | ✓ | PA | QL |
| UnitedHealthcare NC Individual & Family 2026 | Unknown | — | — | ✓ | QL |