Wide-Seal Silicone Diaphr
Generic: diaphragm wide seal 60 mm, 65 mm, 70 mm, 75 mm, 80 mm, 85 mm, 90 mm, 95 mm
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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 Advantage 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier A - ACA $0 Copay | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier A - ACA $0 Copay | — | — | — | None |