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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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 1 hour, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Local 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Advantage 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Care 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Value 2026 Tier 1 - Lowest Cost Generic None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 1 hour, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
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Tier 1 - Basic Core Formulary PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 1 hour, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
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Tier 4 - Higher Cost PA | QL
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