Byetta

Generic: exenatide

10 Mcg — Pen Injector

Hypoglycemics - Injectable — Rapid Acting Insulin

Also known as: Byetta 5 Mcg Dose Pen Injector Byetta 10 Mcg Dose Pen Injector
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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: Jan 1, 2026  ·  Checked: 10 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver 3000 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold RD CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze CMS Standard
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold RD CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze CMS Standard Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect myDiabetesCare Silver
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 2200 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold 1500 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect myDiabetesCare Bronze
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 5500 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD 6000 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver 3500 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD 5000 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 3500 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 7000 HSA Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver 4400 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 5000 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 6500 Indiv Med Deductible
via exenatide 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect myDiabetesCare Silver Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 10 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP)
via exenatide 		Tier 1 - Preferred Generic ✓ — ✓ 2.4 per 30 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 10 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred ✓ ✓ — PA | ST
NC Medicaid Preferred Drug List 2026
via exenatide 		Non-Preferred ✓ ✓ — PA | ST
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 10 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via exenatide 		Tier 3 - Non-Formulary ✓ — — PA
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 10 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Gold Standard (No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Standard (No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
UHC Silver Standard (No Referrals)
via Bydureon 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
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