Yutrepia
Generic: treprostinil
26.5MCG, 53MCG, 79.5MCG, 106MCG — Inhaler
Also known as:
treprostinil
YUTREPIA CAPS 26.5MCG, 53MCG, 79.5MCG, 106MCG
YUTREPIA CAPS 26.5MCG, 53MCG, 79.5MCG,
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
87 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via treprostinil |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Clear Silver with $0 Insulin Options
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold with Atrium Health
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield Federal
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Orenitram |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Orenitram |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Orenitram |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Remodulin |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Remodulin |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Orenitram Titration |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Orenitram Titration |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Orenitram Titration |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Orenitram Titration |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Advantage 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Advantage 2026
via Orenitram Titration |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
|
BCBSNC Blue Advantage 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
| BCBSNC Blue Value 2026 | Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
| BCBSNC Blue Care 2026 | Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
| BCBSNC Blue Local 2026 | Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 5 - Specialty | ✓ | — | ✓ Limited Distribution | PA | QL |
Cigna
1 planMedicare Part D
85 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Orenitram |
Tier 1 - Preferred Generic | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Orenitram |
Tier 1 - Preferred Generic | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Orenitram |
Tier 1 - Preferred Generic | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
HealthSpring True Choice (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring TotalCare (HMO D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring Preferred (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring Preferred Select (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring Preferred Savings (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthSpring Preferred Plus (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CORE 001 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE 001 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE 003 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE 005 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
|
Alignment Health Platinum (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health smartHMO (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Platinum Select (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Alignment Health AVA (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
HealthTeam Advantage Plan I (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
HealthTeam Advantage Plan II (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
HealthTeam Advantage Vitality Plan (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Troy Medicare (HMO)
via Tyvaso |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Tyvaso |
Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Tyvaso |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Erickson Advantage Signature (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Erickson Advantage Freedom (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Erickson Advantage Liberty (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Complete Care NC-25 (HMO-POS C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Complete Care NC-27 (HMO-POS C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
UHC Complete Care NC-28 (HMO-POS C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
|
Erickson Advantage Champion (HMO-POS C-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ 504 per 365 days | PA | QL |
| DEVOTED CHOICE 008 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 5 - Specialty | ✓ | — | ✓ 224 per 28 days | PA | QL |
|
Blue Medicare PPO Enhanced (PPO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Blue Medicare Essential Plus (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Blue Medicare Enhanced (HMO-POS)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Blue Medicare Choice (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Blue Medicare Essential (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Experience Health Medicare Advantage (HMO)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via Orenitram |
Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via treprostinil |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via treprostinil |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via treprostinil |
Tier 4 - Specialty Generic | ✓ | — | — | PA |
|
NC State Health Plan - HDHP 2026
via Orenitram |
Tier 5 - Preferred Brand Specialty | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Orenitram |
Tier 5 - Preferred Brand Specialty | ✓ | — | — | PA |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Orenitram |
Tier 5 - Preferred Brand Specialty | ✓ | — | — | PA |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Tyvaso |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via Tyvaso |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Tyvaso |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Remodulin |
Not Covered | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Remodulin |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Remodulin |
Not Covered | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |
UnitedHealthcare
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UnitedHealthcare NC Individual & Family 2026
via Orenitram |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
UnitedHealthcare NC Individual & Family 2026
via Tyvaso |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |