Zymfentra 2-Syringe

Generic: infliximab-dyyb

Prefilled Syringe

Coverage by Insurer

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

Ambetter (Centene)

34 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 18 hours, 42 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Focused Silver with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver $0 Rx Options via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Clear Silver with $0 Insulin Options via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Silver via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Gold via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Complete Gold via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Silver with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Gold with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Complete Gold + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Silver + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Gold + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Silver with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Signature Gold with Atrium Health + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Enhanced CHF Heart Care Silver $0 Rx Options via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Streamlined Silver with Atrium Health via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Streamlined Silver via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Clear Silver with $0 Insulin Options + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental via Inflectra	Tier 5 - Specialty	✓	—	—	PA

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 18 hours, 42 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Care 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Value 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Local 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL

Medicare Part D

1 plan

Source: CMS QHP JSON · Formulary date: Sep 16, 2026 · Checked: 18 hours, 42 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Longevity Health Plan (HMO I-SNP) via Zymfentra	Tier 1 - Preferred Generic	✓	—	✓ 2 per 28 days	PA \| QL

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 18 hours, 42 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Inflectra	Non-Preferred	✓	✓	—	PA \| ST