Xphozah

Generic: tenapanor

20MG, 30MG — Tablet

Also known as: XPHOZAH TABS 20MG, 30MG Xphozah Oral Tablet

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

10 plans

Source: CMS QHP JSON · Checked: 17 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
AmeriHealth Caritas Next Silver Premier + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Silver Signature + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Silver Essential + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Bronze Premier + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Bronze Signature + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Gold Premier + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Bronze Essential + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL
AmeriHealth Caritas Next Gold Signature + No Referrals	Tier 5 - Specialty	✓	—	✓	PA \| QL

2 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 17 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Basic Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None

2 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 17 hours, 26 minutes ago

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

6 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 17 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Ibsrela	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Ibsrela	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Ibsrela	Not Covered	—	—	—	None