leuprolide acetate injection

1 MG/0.2ML — Kit

Hormonal Agents, Suppressant (pituitary)

Also known as: Leuprolide Acetate Injection Kit

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: 16 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 5 - Specialty None
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty None
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