Monoject

Generic: /needle (disp)

0.5 Ml, 28G — Prefilled Syringe

Also known as: Monoject Syringe/12Ml/20G Monoject 3Ml Syringe/ Stan Monoject Syringe/Luer Loc Monoject Syringe/Luer- Loc Monoject Syringe/ Standard Monoject Syringe/12Ml/18G Monoject Syringe 0.3 Ml Monoject Syringe 0.5 Ml Monoject Syringe 0.5 Ml 28G 1/2" Monoject Syringe 1 Ml Monoject Syringe 1 Ml 27 1/2" Monoject Syringe 1 Ml 28G 1/2" Monoject Syringe 3 Ml 20G 1" Monoject Syringe 3 Ml 20G 1.5" Monoject Syringe 3 Ml 20G 3/4" Monoject Syringe 3 Ml 21G 1" Monoject Syringe 3 Ml 21G 1.5" Monoject Syringe 3 Ml 22G 1" Monoject Syringe 3 Ml 22G 1.5" Monoject Syringe 3 Ml 23G 1" Monoject Syringe 3 Ml 25G 5/8" Monoject Syringe 3 Ml 25G 1" Monoject Syringe 3 Ml 25G 1.25" Monoject Syringe 3 Ml 27G 1.25" Monoject Syringe 6 Ml 20G 1.5" Monoject Syringe 6 Ml 21G 1" Monoject Syringe 6 Ml 21G 1.5" Monoject Syringe 6 Ml 22G 1.5"

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Blue Cross Blue Shield of NC

240 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 18 hours, 47 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Magellan	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 Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Ulticare	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None

Cigna

9 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 18 hours, 47 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Bd Eclipse	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Integra	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Luer-Lok	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Safetyglide	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Easy Touch Safety	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Securesafe	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Ulticare	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Vanishpoint	Tier 2 - Preferred Brand	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 18 hours, 47 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Securesafe	Not Covered	—	—	—	None