Gvoke Pfs
Generic: glucagon subcutaneous
1MG/0.2ML — Prefilled Syringe
Also known as:
GVOKE PFS SOSY 1MG/0.2ML
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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
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Focus 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Standard Option 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Standard Option 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Standard Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Basic Option 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Basic Option 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
Blue Cross Blue Shield of NC
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Gvoke Hypopen 2-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Gvoke Hypopen 2-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Gvoke Hypopen 2-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Gvoke Hypopen 2-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 3 - High Cost Brand | — | — | — | None |
| BCBSNC Blue Value 2026 | Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Gvoke Hypopen 1-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Gvoke Hypopen 1-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Local 2026
via Gvoke Hypopen 1-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via Gvoke Hypopen 1-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via Gvoke Hypopen 1-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Gvoke Hypopen 2-Pack |
Tier 3 - High Cost Brand | — | — | — | None |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Gvoke Hypopen 2-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Gvoke Hypopen 1-Pack |
Tier 2 - Non-Preferred Generic | — | — | — | None |
UnitedHealthcare
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UnitedHealthcare NC Individual & Family 2026 | Unknown | — | — | ✓ | QL |
|
UnitedHealthcare NC Individual & Family 2026
via Gvoke Hypopen 2-Pack |
Unknown | — | — | ✓ | QL |
|
UnitedHealthcare NC Individual & Family 2026
via Gvoke Hypopen 1-Pack |
Unknown | — | — | ✓ | QL |