Varubi

Generic: rolapitant

90 MG — Tablet

ULCER DRUGS

Also known as: rolapitant VARUBI TBPK 90MG
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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: 22 hours, 6 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Streamlined Silver Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze Tier 4 - Non-Preferred ✓ — — PA
Signature Silver + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Gold + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze Tier 4 - Non-Preferred ✓ — — PA
Signature Silver Tier 4 - Non-Preferred ✓ — — PA
Signature Gold Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Streamlined Silver with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Complete Gold + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Complete Gold Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze + Vision + Adult Dental Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options Tier 4 - Non-Preferred ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 22 hours, 6 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 4 - Non-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 22 hours, 6 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 2 - Preferred Brand — — ✓ QL
BCBS Federal Focus 2026 Tier 2 - Preferred Brand — — ✓ QL
BCBS Federal Basic Option 2026 Tier 2 - Preferred Brand — — ✓ QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 22 hours, 6 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026 Tier 3 - High Cost Brand — — — Limited Distribution None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 3 - High Cost Brand — — — Limited Distribution None
BCBSNC Blue Care 2026 Tier 3 - High Cost Brand — — — Limited Distribution None
BCBSNC Blue Advantage 2026 Tier 3 - High Cost Brand — — — Limited Distribution None
BCBSNC Blue Local 2026 Tier 3 - High Cost Brand — — — Limited Distribution None
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 22 hours, 5 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — — PA
Source: CMS QHP JSON  ·  Checked: 22 hours, 5 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AIAN Cost Share Tier 3 - Preferred Brand ✓ — — PA
Bronze Elite + PCP Saver Plus Tier 3 - Preferred Brand ✓ — — PA
Silver Classic Tier 3 - Preferred Brand ✓ — — PA
Secure Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic 4700 Tier 3 - Preferred Brand ✓ — — PA
Silver Simple PCP Saver Tier 3 - Preferred Brand ✓ — — PA
Gold Elite Saver Plus Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Diabetes Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic Standard Tier 3 - Preferred Brand ✓ — — PA
Silver Classic Standard Tier 3 - Preferred Brand ✓ — — PA
Gold Classic Standard Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic Standard | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Classic Standard | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Gold Classic Standard | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Secure | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic 4700 | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Classic | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Diabetes | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Simple PCP Saver | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Gold Elite Saver Plus | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Diabetes | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Chronic Care CKM | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
AIAN Cost Share | with Atrium Health Tier 3 - Preferred Brand ✓ — — PA
Source: PDF  ·  Formulary date: Sep 23, 2026  ·  Checked: 22 hours, 5 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Standard (HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals) Tier 4 - Non-Preferred — — ✓ QL
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