Xofluza

Generic: baloxavir marboxil

40MG, 80MG — Tablet

ANTHELMINTICS

Also known as: baloxavir marboxil XOFLUZA TBPK 40MG, 80MG

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: 23 hours, 56 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand None
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand None
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 23 hours, 56 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026 Tier 4 - Higher Cost Brand QL
BCBSNC Blue Advantage 2026 Tier 4 - Higher Cost Brand QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 4 - Higher Cost Brand QL
BCBSNC Blue Local 2026 Tier 4 - Higher Cost Brand QL
BCBSNC Blue Care 2026 Tier 4 - Higher Cost Brand QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 23 hours, 56 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic 1 per 30 days QL
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic None
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic None
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
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic 1 per 30 days QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic 1 per 30 days QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
Erickson Advantage Signature (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
Erickson Advantage Freedom (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
Erickson Advantage Liberty (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
Erickson Advantage Champion (HMO-POS C-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 3 - Preferred Brand 1 per 30 days QL
HealthTeam Advantage Plan I (PPO) Tier 3 - Preferred Brand None
HealthTeam Advantage Plan II (PPO) Tier 3 - Preferred Brand None
HealthTeam Advantage Vitality Plan (PPO) Tier 3 - Preferred Brand None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 3 - Preferred Brand None
Liberty Medicare Advantage (HMO C-SNP) Tier 4 - Non-Preferred 1 per 30 days QL
Blue Medicare PPO Enhanced (PPO) Tier 4 - Non-Preferred 2 per 365 days QL
Blue Medicare Essential Plus (HMO-POS) Tier 4 - Non-Preferred 2 per 365 days QL
Blue Medicare Enhanced (HMO-POS) Tier 4 - Non-Preferred 2 per 365 days QL
Blue Medicare Choice (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Blue Medicare Essential (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Experience Health Medicare Advantage (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health Platinum (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health smartHMO (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health Platinum Select (HMO) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 4 - Non-Preferred 2 per 365 days QL
Alignment Health AVA (PPO) Tier 4 - Non-Preferred 2 per 365 days QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 4 - Non-Preferred None
HealthSpring TotalCare (HMO D-SNP) Tier 4 - Non-Preferred None
HealthSpring True Choice (PPO) Tier 4 - Non-Preferred None
Senior Care (HMO I-SNP) Tier 4 - Non-Preferred 1 per 30 days QL
HealthSpring Preferred Plus (HMO) Tier 4 - Non-Preferred None
HealthSpring Preferred Savings (HMO) Tier 4 - Non-Preferred None
HealthSpring Preferred Select (HMO) Tier 4 - Non-Preferred None
HealthSpring Preferred (HMO) Tier 4 - Non-Preferred None
Something not right?