insulin lispro-aabc

Generic: Lyumjev

100 unit/mL — Pen Injector

INSULINS

Also known as: LYUMJEV TEMPO PEN U-100
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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  ·  Formulary date: Sep 22, 2026  ·  Checked: 3 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Lyumjev 		Brand-Preferred — — — None
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Lyumjev 		Brand-Preferred — — — None
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Lyumjev 		Brand-Preferred — — — None
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
via Lyumjev 		Brand-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via Lyumjev 		Tier 3 - Non-Preferred Brand — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026
via Lyumjev Kwikpen 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Care 2026
via Lyumjev 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Value 2026
via Lyumjev 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Lyumjev 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Local 2026
via Lyumjev Kwikpen 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Value 2026
via Lyumjev Kwikpen 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Lyumjev Kwikpen 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Advantage 2026
via Lyumjev Kwikpen 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Local 2026
via Lyumjev 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Advantage 2026
via Lyumjev 		Tier 3 - High Cost Brand — — ✓ QL
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
Liberty Medicare Dual Plan (HMO D-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
NHC Advantage (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
Longevity Health Plan (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
PruittHealth Premier (HMO I-SNP)
via Lyumjev 		Tier 1 - Preferred Generic — — — None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-25 (HMO-POS C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-27 (HMO-POS C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-28 (HMO-POS C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Alignment Health Platinum (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health smartHMO (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Platinum Select (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Erickson Advantage Signature (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Guardian (HMO-POS I-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Champion (HMO-POS C-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Freedom (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Liberty (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Alignment Health AVA (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthSpring True Choice (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Healthy Blue + Medicare (HMO-POS D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthSpring TotalCare (HMO D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare Plus (HMO D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Savings (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Plus (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Plan I (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Plan II (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Vitality Plan (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Select (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S001 (PPO D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S2 (PPO D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
Blue Medicare PPO Enhanced (PPO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Essential Plus (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Enhanced (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Choice (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Essential (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Experience Health Medicare Advantage (HMO)
via Lyumjev 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Senior Care (HMO I-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Lyumjev 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Lyumjev 		Tier 6 - Specialty Plus — — — None
Liberty Medicare Advantage (HMO C-SNP)
via Lyumjev 		Tier 6 - Specialty Plus — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Lyumjev 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Lyumjev Tempo 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Lyumjev Tempo 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Lyumjev Tempo 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Lyumjev 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Lyumjev 		Not Covered — — — None
Source: Excel (XLSX)  ·  Formulary date: Jul 31, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
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