Andembry

Generic: garadacimab-gxii

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

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 44 minutes ago

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

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 2 hours, 44 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via garadacimab-gxii	Tier 3 - Non-Formulary	✓	—	—	PA