insulin detemir

100 unit/mL, 100 unit/mL (3 mL) — Vial

INSULINS

Also known as: LEVEMIR LEVEMIR FLEXPEN
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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: CMS QHP JSON  ·  Checked: 19 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Essential + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Silver Premier + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Gold Signature + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Silver Signature + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas Next Gold Premier + No Referrals
via Levemir 		Tier 4 - Non-Preferred — ✓ — ST
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 19 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via Levemir 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Levemir 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Levemir 		Not Covered — — — None
Source: CMS QHP JSON  ·  Checked: 19 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Classic | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Secure | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Classic 4700 | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple Diabetes | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple PCP Saver | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Gold Elite Saver Plus | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Simple Chronic Care CKM | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Simple Diabetes | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple Chronic Care CKM | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
AIAN Cost Share
via Levemir 		Tier 3 - Preferred Brand — — — None
AIAN Cost Share | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Classic Standard
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Classic Standard
via Levemir 		Tier 3 - Preferred Brand — — — None
Gold Classic Standard
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Classic Standard | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Classic Standard | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Gold Classic Standard | with Atrium Health
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Elite + PCP Saver Plus
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Classic
via Levemir 		Tier 3 - Preferred Brand — — — None
Secure
via Levemir 		Tier 3 - Preferred Brand — — — None
Bronze Classic 4700
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple PCP Saver
via Levemir 		Tier 3 - Preferred Brand — — — None
Gold Elite Saver Plus
via Levemir 		Tier 3 - Preferred Brand — — — None
Silver Simple Diabetes
via Levemir 		Tier 3 - Preferred Brand — — — None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 19 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 19 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Standard (No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Standard (No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Standard (No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Levemir 		Tier 0 - $0 Preventive — — ✓ QL
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