filgrastim-ayow

Generic: Releuko

300 mcg/0.5 mL, 480 mcg/0.8 mL — Prefilled Syringe

Also known as: RELEUKO

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

10 plans

Source: CMS QHP JSON · Checked: 19 hours, 8 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Signature + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Gold Signature + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Bronze Premier + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Premier + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Silver Essential + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Gold Premier + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Bronze Essential + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA
AmeriHealth Caritas Next Bronze Signature + No Referrals via Releuko	Tier 5 - Specialty	✓	—	—	PA

2 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 19 hours, 8 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via Releuko	Tier 5 - Non-Preferred Specialty	✓	—	—	PA
BCBS Federal Basic Option 2026 via Releuko	Tier 5 - Non-Preferred Specialty	✓	—	—	PA

1 plan

Source: CMS QHP JSON · Formulary date: Jun 10, 2026 · Checked: 19 hours, 8 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Longevity Health Plan (HMO I-SNP) via Releuko	Tier 1 - Preferred Generic	✓	—	—	PA

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 19 hours, 8 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Releuko	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Releuko	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Releuko	Not Covered	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 19 hours, 8 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	—	PA