Bd Luer-Lok

Generic: /needle (disp)

3 Ml, 25G — Prefilled Syringe

Also known as: Bd Luer-Lok Syringe W/Ecl Bd Luer-Lok Syringe 3 Ml 25G 5/8"

Coverage by Insurer

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

Blue Cross Blue Shield of NC

240 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 22 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None

Cigna

80 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Connect Bronze CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Bronze via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold RD CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Silver via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Silver via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Bronze via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Silver via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Bronze via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold RD CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze CMS Standard via Bd Eclipse	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold RD CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze CMS Standard via Monoject	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold RD CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze CMS Standard via Securesafe	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Silver via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 2200 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold 1500 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect myDiabetesCare Bronze via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 5500 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 6000 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3500 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze RD 5000 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 3500 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 7000 HSA Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 4400 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD 5000 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver 3000 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Bronze 6500 Indiv Med Deductible via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Silver RD CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None
Connect Gold CMS Standard via Ulticare	Tier 3 - Preferred Brand	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 22 hours, 1 minute ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Securesafe	Not Covered	—	—	—	None