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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.
TRICARE
1 plan| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 2 - Brand Formulary | — | — | ✓ INTRACAVERNOSAL CAVERJECT (PS 1) TO BE DISP AT MAX QTY OF 6 UNITS IN 23D OR 18 UNITS IN 68D | QL Quantity limit |