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Dalvance
UnitedHealthcare (UHC)
UnitedHealthcare (UHC) Coverage for Dalvance
All
8
Commercial
4
Health Exchange
2
Medicare
2
Commercial
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Commercial - Other Insurer
No PA
No Step Therapy
No Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - HMO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
Medicare - Prescription Drug Plan
PA Required
Step Therapy
No Quantity Limit
See Details
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