Emgality Sosy

120MG

.25%, .5%

Also known as: EMGALITY SOSY 120MG/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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 4 hours, 27 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 2 - Non-Preferred Generic ✓ ✓ ✓ (prefilled PA | ST | QL
NC State Health Plan - 70/30 Standard PPO 2026 Tier 2 - Non-Preferred Generic ✓ ✓ ✓ (prefilled PA | ST | QL
NC State Health Plan - HDHP 2026 Tier 2 - Non-Preferred Generic ✓ ✓ ✓ (prefilled PA | ST | QL
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