Diazepam Rectal

2.5 mg, 10 mg, 20 mg — Gel

Also known as: Diazepam Rectal Gel diazepam rectal gel delivery system 10 mg, 20 mg diazepam rectal gel delivery system 2.5 mg, 10 mg, 20 mg

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

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 50 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 2 - Medium Cost Generic/Brand	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 20 hours, 50 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Tier 3 - Mid-Range Cost	—	—	✓	QL