Xcopri (250 MG Daily Dose)
250 MG — Tablet
Also known as:
Xcopri (250 MG Daily Dose) Oral Tablet Therapy Pack
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 4 - Non-Preferred | — | ✓ | ✓ | ST | QL |