Cimzia (2

200MG — Prefilled Syringe

Tumor Necrosis Factor Blocker

Also known as: Cimzia (2 Syringe) Cimzia (2 Syringe) Subcutaneous Prefilled Syringe Kit CIMZIA (2 SYRINGE)- certolizumab pegol prefilled syringe kit 200 mg/ml CIMZIA (2 SYRINGE) PSKT 200MG/ML
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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: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026 Tier 5 - Non-Preferred Specialty ✓ — — PA
BCBS Federal Standard Option 2026 Tier 5 - Non-Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Value 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Advantage 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Local 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Tier 6 - Non-Preferred Brand Specialty ✓ — — Preferred for Non- PA
NC State Health Plan - 80/20 Plus PPO 2026 Tier 6 - Non-Preferred Brand Specialty ✓ — — Preferred for Non- PA
NC State Health Plan - HDHP 2026 Tier 6 - Non-Preferred Brand Specialty ✓ — — Preferred for Non- PA
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