insulin lispro U-100 KwikPen

Vial

Hypoglycemics - Injectable — Rapid Acting Insulin

Also known as: Humalog
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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: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Signature + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Gold Signature + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Gold Premier + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas Next Silver Essential + No Referrals
via Humalog 		Tier 3 - Preferred Brand — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026
via Humalog 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Advantage 2026
via Humalog 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Humalog 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Value 2026
via Humalog 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Local 2026
via Humalog 		Tier 3 - High Cost Brand — — ✓ QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze 6500 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Gold RD CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD 6000 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 3500 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD 5000 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 3500 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze 7000 HSA Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 4400 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 5000 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 3000 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Gold CMS Standard
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect myDiabetesCare Silver
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 2200 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Gold 1500 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect myDiabetesCare Bronze
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze 5500 Indiv Med Deductible
via Humalog 		Tier 3 - Preferred Brand — — ✓ QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
PruittHealth Premier (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Liberty Medicare Dual Plan (HMO D-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
NHC Advantage (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Humalog 		Tier 1 - Preferred Generic — — — None
Blue Medicare Essential (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Experience Health Medicare Advantage (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Healthy Blue + Medicare (HMO-POS D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Platinum (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health NC Duals (HMO-POS D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Platinum Select (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Alignment Health AVA (PPO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Plan I (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Plan II (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthTeam Advantage Vitality Plan (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
Troy Medicare (HMO)
via Humalog 		Tier 3 - Preferred Brand — — — None
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
Senior Care (HMO I-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
Alignment Health smartHMO (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
UHC Dual Complete NC-S001 (PPO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S2 (PPO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Signature (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Guardian (HMO-POS I-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Freedom (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Liberty (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-25 (HMO-POS C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-27 (HMO-POS C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-28 (HMO-POS C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Champion (HMO-POS C-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring True Choice (PPO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare (HMO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring TotalCare Plus (HMO D-SNP)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred (HMO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Select (HMO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Savings (HMO)
via Humalog 		Tier 3 - Preferred Brand — — — None
HealthSpring Preferred Plus (HMO)
via Humalog 		Tier 3 - Preferred Brand — — — None
Blue Medicare PPO Enhanced (PPO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Essential Plus (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Enhanced (HMO-POS)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Blue Medicare Choice (HMO)
via Humalog 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Humalog 		Tier 6 - Specialty Plus — — — None
Liberty Medicare Advantage (HMO C-SNP)
via Humalog 		Tier 6 - Specialty Plus — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred — ✓ — ST
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 13 hours, 38 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Standard (No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Standard (No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
UHC Gold Standard (No Referrals)
via Humalog 		Tier 0 - $0 Preventive — — ✓ QL
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