Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Cigna
60 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Silver RD 2200 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3600 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold RD CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze CMS Standard
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3600 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 5000 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Easymax |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Bronze
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 3600 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect myDiabetesCare Silver
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver 5000 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via Embrace |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via True Metrix Glucose Test Strip |
Tier 3 - Preferred Brand | — | — | — | None |
NC State Health Plan
60 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Agamatrix |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Agamatrix |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Agamatrix |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Caresens N |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Caresens N |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Caresens N |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Diatrue Plus |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Diatrue Plus |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Diatrue Plus |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Plus Ii |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Plus Ii |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easy Plus Ii |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Step |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Step |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easy Step |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Talk |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Talk |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easy Talk |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Trak |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Trak |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easy Trak |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easymax 15 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easymax 15 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easymax 15 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Easymax |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Easymax |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Easymax |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Embrace |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Embrace |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Embrace |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora D15G |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora D15G |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora D15G |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora D20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora D20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora D20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora G20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora G20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora G20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V10 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V10 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora V10 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V12 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V12 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora V12 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora V20 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V30A |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V30A |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Fora V30A |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Microdot |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Microdot |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Microdot |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Quintet Ac |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Quintet Ac |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Quintet Ac |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Unistrip1 |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Unistrip1 |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Unistrip1 |
Not Covered | — | — | — | None |
TRICARE
145 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
TRICARE Uniform Formulary 2026
via Telcare |
Tier 2 - Brand Formulary | ✓ | — | ✓ SELECT LANCETS TO BE DISP AT MAX QTY OF 204 UNITS IN 22 DAYS OR 612 UNITS IN 68 DAYS | PA | QL PA on 1 of 2 NDCs: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Embrace |
Tier 2 - Brand Formulary | ✓ | — | ✓ SELECT SYRINGES,NEEDLES,SUPPLIES TO BE DISPENSED AT MAX QTY OF 200 UNITS IN 22D OR 600 UNITS IN 68D | PA | QL PA on 2 of 10 NDCs: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Precision Xtra |
Tier 2 - Brand Formulary (Basic Core) | — | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | QL Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora Gtel Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora Tn'g Advan Pro Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora Tn'g Voice Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora V10 |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora V12 |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora V20 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora V30A |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Foracare GD20 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Foracare GD40 |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Freestyle Insulinx |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Freestyle Insulinx Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Freestyle Precision Neo |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via GE100 Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via GE333 Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Genstrip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Gluco Navii |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Glucocard 01 Sensor Plus |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Glucocard Expression |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Glucocard Shine |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Glucocard Vital |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Glucocard Vital Sensor |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Glucocom Glucose |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Gojji Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Harmony Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Healthpro Glucose Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Ihealth Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via INFINITY TEST STRIPS |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Micro |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Microdot |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Microdot Xtra |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Mobi Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Myglucohealth |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Neutek 2TEK Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Nova Max Glucose Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via On Call Express Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via On Call Plus Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via On Call Vivid Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Onetouch Ultra Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Onetouch Verio Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Optium Ez |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Optumrx |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Pharmacist Choice |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Pip Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Platinum Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Precision Point Of Care |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Premier Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Premium Blood Glucose Test |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Premium V10 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Pro Voice V8-V9 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Prodigy No Coding |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Quintet |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Quintet Ac |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Refuah Plus |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Relion Confirm-micro |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Relion Prime Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Reveal Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Rightest GS100 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Rightest GS300 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Rightest GS550 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Rightest GT333 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Smart Sense Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Smartest Test |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Solus V2 Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Sure-test Easyplus Mini |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Test N'go |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via True Metrix Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via True Metrix Pro Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Trueness Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Truetest Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Truetrack Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Ultima |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Ultratrak |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Ultratrak Ultimate |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Unistrip1 |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Vivaguard Ino Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Precision Q-i-d |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fortiscare G1 Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fortiscare Glucose Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora D40-G31 Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora D20 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora D15G |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora 6CONN-GTEL-TN'G Adv Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora 6 Connect Glucose Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Ez Smart Plus |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Ez Smart |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Evolution Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Evencare Proview Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Evencare Mini Glucose Test Str |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Evencare G3 |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Evencare G2 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Embrace Wave Glucose Test Strp |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Embrace Talk Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Embrace Pro Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Embrace Evo |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Element Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Element Compact |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Easymax 15 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Easymax |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Easygluco Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
| TRICARE Uniform Formulary 2026 | Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Easy Trak |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Easy Touch Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 1 of 4 NDCs |
|
TRICARE Uniform Formulary 2026
via Easy Touch Blulink Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Easy Talk Plus Ii |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Easy Talk |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Easy Step |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Easy Plus Ii |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Diatrue Plus |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Contour Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Contour Plus Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Contour Next Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 3 of 5 NDCs |
|
TRICARE Uniform Formulary 2026
via Clever Choice Voice+ Tst Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Clever Choice Test Strips |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Clever Choice Talk |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Clever Choice Pro |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Clever Choice Micro Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Caretouch Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Caresens S Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora G20 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Blulink Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Blood Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 11 of 20 NDCs |
|
TRICARE Uniform Formulary 2026
via Assure Titanium Test Strip |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 1 of 4 NDCs |
|
TRICARE Uniform Formulary 2026
via Assure Prism Multi |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Assure Platinum Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Assure Platinum |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Assure 4 |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Agamatrix Presto |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Agamatrix Jazz Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Agamatrix |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Advocate Redi-code+ |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Advanced Glucose Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Advanced Glucose Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Accutrend Glucose |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Accu-chek Smartview |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Accu-chek Guide Test Strip |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Accu-chek Aviva Plus |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Caresens N |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |
|
TRICARE Uniform Formulary 2026
via Fora G30-PREMIUM V10 Test Strp |
Tier 3 - Non-Formulary | ✓ | — | ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN | PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit |
|
TRICARE Uniform Formulary 2026
via Fora GD50 Test Strips |
Tier 3 - Non-Formulary | ✓ | — | — | PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION |