Gattex
Generic: teduglutide
5 Mg — Vial
GASTROINTESTINAL AGENTS- MISC.
Also known as:
teduglutide
GATTEX KIT 5MG
Gattex 5 Mg Vial
Gattex 5 Mg 30-Vial Kit
Gattex 5 Mg One-Vial Kit
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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | ✓ | — | — | PA |
| BCBS Federal Basic Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
| BCBS Federal Standard Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Care 2026 | Tier 5 - Specialty | ✓ | — | — Limited Distribution | PA |
| BCBSNC Blue Value 2026 | Tier 5 - Specialty | ✓ | — | — Limited Distribution | PA |
| BCBSNC Blue Advantage 2026 | Tier 5 - Specialty | ✓ | — | — Limited Distribution | PA |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 5 - Specialty | ✓ | — | — Limited Distribution | PA |
| BCBSNC Blue Local 2026 | Tier 5 - Specialty | ✓ | — | — Limited Distribution | PA |
Cigna
1 planMedicare Part D
55 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
| Aetna Medicare Enhanced (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Enhanced (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature Extra (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature Giveback (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring True Choice (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring TotalCare (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring Preferred (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring Preferred Select (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring Preferred Savings (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| HealthSpring Preferred Plus (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Dual (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Value Plus (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Prime (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature Care (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Enhanced (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Aetna Medicare Signature (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health AVA (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CORE 001 NC (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE 001 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE 003 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE 005 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE 008 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Platinum (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health smartHMO (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Platinum Select (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - HDHP 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |