Xopenex HFA

Generic: levalbuterol tartrate

Inhaler

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 17 hours, 29 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Levalbuterol Tartrate Hfa	Tier 1 - Generic	—	—	✓	QL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 29 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 17 hours, 28 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via levalbuterol tartrate	Tier 3 - Non-Formulary	—	—	✓	QL