Ajovy

Generic: fremanezumab-vfrm subcutaneous

225 MG/1.5 ML — Auto-Injector

MIGRAINE PRODUCTS

Also known as: Ajovy 225 Mg/1.5 Ml Auto-Injector Ajovy 225 Mg/1.5Ml Auto-Injector (X3) Ajovy 225 Mg/1.5 Ml Syringe
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 14 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Local 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Care 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Value 2026 Tier 3 - High Cost Brand ✓ — ✓ Restricted Access PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 14 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect myDiabetesCare Silver Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Gold CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Gold RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze CMS Standard Tier 3 - Preferred Brand ✓ — — PA
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