Androgel Pump

Generic: testosterone td

1.62% — Gel

Androgenic Agents

Also known as: ANDROGEL PUMP GEL 1.62%

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: Apr 1, 2026  ·  Checked: 19 hours, 12 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand PA | QL
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand PA | QL
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand PA | QL
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 12 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 12 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
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