venlafaxine

112.5 MG — Tablet

Antidepressants — Other

Also known as: Venlafaxine 25 Mg Tablet Venlafaxine 37.5 Mg Tablet Venlafaxine 50 Mg Tablet Venlafaxine 75 Mg Tablet Venlafaxine 100 Mg Tablet Venlafaxine Er 150 Mg Capsule Venlafaxine Er 37.5 Mg Capsule Venlafaxine Er 75 Mg Capsule

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: 9 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Standard Expanded Bronze + Vision + Adult Dental Tier 2 - Generic None
Complete Gold Tier 2 - Generic None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 2 - Generic None
Everyday Bronze Tier 2 - Generic None
Elite Bronze Tier 2 - Generic None
Clear Silver with $0 Insulin Options Tier 2 - Generic None
Standard Expanded Bronze Tier 2 - Generic None
Standard Silver Tier 2 - Generic None
Complete Gold with Atrium Health Tier 2 - Generic None
Standard Expanded Bronze with Atrium Health Tier 2 - Generic None
Standard Silver with Atrium Health Tier 2 - Generic None
Standard Gold with Atrium Health Tier 2 - Generic None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 2 - Generic None
Complete Gold + Vision + Adult Dental Tier 2 - Generic None
Everyday Bronze + Vision + Adult Dental Tier 2 - Generic None
Elite Bronze + Vision + Adult Dental Tier 2 - Generic None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Standard Gold Tier 2 - Generic None
Everyday Bronze with Atrium Health Tier 2 - Generic None
Elite Bronze with Atrium Health Tier 2 - Generic None
Focused Silver with Atrium Health Tier 2 - Generic None
Standard Gold with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 2 - Generic None
Standard Gold + Vision + Adult Dental Tier 2 - Generic None
Standard Silver + Vision + Adult Dental Tier 2 - Generic None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 9 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 1 - Generic QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 9 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Wellcare Simple (HMO-POS) Tier 1 - Preferred Generic None
Wellcare Giveback Open (PPO) Tier 1 - Preferred Generic None
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic None
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic None
HealthSpring Preferred Plus (HMO) Tier 1 - Preferred Generic 60 per 30 days QL
Liberty Medicare Advantage (HMO C-SNP) Tier 1 - Preferred Generic None
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic 30 per 30 days QL
HealthSpring True Choice (PPO) Tier 1 - Preferred Generic 60 per 30 days QL
Senior Care (HMO I-SNP) Tier 1 - Preferred Generic None
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic None
HealthSpring Preferred (HMO) Tier 1 - Preferred Generic 60 per 30 days QL
HealthSpring Preferred Select (HMO) Tier 1 - Preferred Generic 60 per 30 days QL
HealthSpring Preferred Savings (HMO) Tier 1 - Preferred Generic 60 per 30 days QL
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic None
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic None
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic None
Wellcare Simple Open (PPO) Tier 1 - Preferred Generic None
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic None
Aetna Medicare Signature (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 2 - Generic 60 per 30 days QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 2 - Generic None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 2 - Generic None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 2 - Generic None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 2 - Generic None
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 2 - Generic None
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) Tier 2 - Generic None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 2 - Generic None
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 2 - Generic None
DEVOTED CORE 001 NC (HMO) Tier 2 - Generic None
DEVOTED GIVEBACK 002 NC (HMO) Tier 2 - Generic None
DEVOTED GIVEBACK 012 NC (HMO) Tier 2 - Generic None
DEVOTED CHOICE 001 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE 003 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE 005 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE 008 NC (PPO) Tier 2 - Generic None
DEVOTED CHOICE GIVEBACK 009 NC (PPO) Tier 2 - Generic None
Blue Medicare PPO Enhanced (PPO) Tier 2 - Generic 30 per 30 days QL
Blue Medicare Essential Plus (HMO-POS) Tier 2 - Generic 30 per 30 days QL
Blue Medicare Enhanced (HMO-POS) Tier 2 - Generic 30 per 30 days QL
Blue Medicare Choice (HMO) Tier 2 - Generic 30 per 30 days QL
Blue Medicare Essential (HMO) Tier 2 - Generic 30 per 30 days QL
Experience Health Medicare Advantage (HMO) Tier 2 - Generic 30 per 30 days QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 2 - Generic 30 per 30 days QL
HealthTeam Advantage Plan I (PPO) Tier 2 - Generic None
HealthTeam Advantage Vitality Plan (PPO) Tier 2 - Generic None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 2 - Generic None
Troy Medicare (HMO) Tier 2 - Generic None
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 2 - Generic None
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 2 - Generic None
HealthTeam Advantage Plan II (PPO) Tier 2 - Generic None
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 2 - Generic None
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 2 - Generic None
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 2 - Generic None
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 2 - Generic None
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 2 - Generic None
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 2 - Generic None
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 2 - Generic None
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 2 - Generic None
Erickson Advantage Signature (HMO-POS) Tier 2 - Generic None
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 2 - Generic None
Erickson Advantage Freedom (HMO-POS) Tier 2 - Generic None
Erickson Advantage Liberty (HMO-POS) Tier 2 - Generic None
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 2 - Generic None
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 2 - Generic None
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 2 - Generic None
Erickson Advantage Champion (HMO-POS C-SNP) Tier 2 - Generic None
Aetna Medicare Signature (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Dual (HMO D-SNP) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Value Plus (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Prime (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature Care (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Enhanced (HMO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Enhanced (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Enhanced (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature Extra (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 2 - Generic 60 per 30 days QL
Aetna Medicare Signature Giveback (PPO) Tier 2 - Generic 60 per 30 days QL
Humana Dual Select H5525-072 (PPO D-SNP) Tier 2 - Generic 60 per 30 days QL
HumanaChoice H5525-083 (PPO) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H6622-025 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H6622-026 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H6622-057 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H6622-060 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H6622-061 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Choice H8145-004 (PFFS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 2 - Generic 60 per 30 days QL
Wellcare Dual Liberty Open (PPO D-SNP) Tier 2 - Generic None
Wellcare Assist Open (PPO) Tier 2 - Generic None
Wellcare Dual Access (HMO-POS D-SNP) Tier 2 - Generic None
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 2 - Generic None
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 2 - Generic None
Humana Gold Plus H1036-137 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H1036-233 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Dual Select H1036-307 (HMO D-SNP) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 2 - Generic 60 per 30 days QL
Humana Gold Plus H1036-335 (HMO-POS) Tier 2 - Generic 60 per 30 days QL
HumanaChoice Giveback H5216-017 (PPO) Tier 2 - Generic 60 per 30 days QL
HumanaChoice H5216-211 (PPO) Tier 2 - Generic 60 per 30 days QL
Humana Full Access H5525-034 (PPO) Tier 2 - Generic 60 per 30 days QL
HumanaChoice Giveback H5525-035 (PPO) Tier 2 - Generic 60 per 30 days QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 2 - Generic 60 per 30 days QL
HumanaChoice H5525-049 (PPO) Tier 2 - Generic 60 per 30 days QL
HumanaChoice H5525-050 (PPO) Tier 2 - Generic 60 per 30 days QL
HumanaChoice H5525-070 (PPO) Tier 2 - Generic 60 per 30 days QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 3 - Preferred Brand 60 per 30 days QL
HealthSpring TotalCare (HMO D-SNP) Tier 3 - Preferred Brand 60 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 4 - Non-Preferred None
Alignment Health Platinum Select (HMO) Tier 4 - Non-Preferred None
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 4 - Non-Preferred None
Alignment Health NC Duals (HMO-POS D-SNP) Tier 4 - Non-Preferred None
Alignment Health Platinum (HMO) Tier 4 - Non-Preferred None
Alignment Health smartHMO (HMO) Tier 4 - Non-Preferred None
Alignment Health AVA (PPO) Tier 4 - Non-Preferred None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 9 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred None
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