Myalept

Generic: metreleptin

5 MG — Injection

Also known as: metreleptin

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

Ambetter (Centene)

34 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 23 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Clear Silver with $0 Insulin Options	Tier 5 - Specialty	✓	—	—	PA
Signature Silver	Tier 5 - Specialty	✓	—	—	PA
Signature Gold	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Focused Silver with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Signature Silver with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Signature Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Signature Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Signature Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze	Tier 5 - Specialty	✓	—	—	PA
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Clear Silver with $0 Insulin Options + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Streamlined Silver	Tier 5 - Specialty	✓	—	—	PA
Streamlined Silver with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Enhanced CHF Heart Care Silver $0 Rx Options	Tier 5 - Specialty	✓	—	—	PA
Signature Expanded Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Signature Gold with Atrium Health	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Complete Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA
Complete Gold	Tier 5 - Specialty	✓	—	—	PA
Enhanced Asthma/COPD Care Silver $0 Rx Options	Tier 5 - Specialty	✓	—	—	PA
Everyday Bronze	Tier 5 - Specialty	✓	—	—	PA
Elite Bronze	Tier 5 - Specialty	✓	—	—	PA
Signature Silver + Vision + Adult Dental	Tier 5 - Specialty	✓	—	—	PA

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 23 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Local 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Care 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL

Oscar Health

28 plans

Source: CMS QHP JSON · Checked: 23 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Silver Classic \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Elite + PCP Saver Plus	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Classic	Tier 5 - Specialty	✓	—	✓	PA \| QL
Secure	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Classic 4700	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple PCP Saver	Tier 5 - Specialty	✓	—	✓	PA \| QL
Gold Elite Saver Plus	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple Diabetes	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Classic Standard	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Classic Standard	Tier 5 - Specialty	✓	—	✓	PA \| QL
Gold Classic Standard	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Classic Standard \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Classic Standard \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Gold Classic Standard \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Simple Chronic Care CKM \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Secure \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Classic 4700 \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Elite + PCP Saver Plus \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple Diabetes \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple PCP Saver \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Gold Elite Saver Plus \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Bronze Simple Diabetes \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple Breathe Easy with Enhanced COPD Benefits \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple Chronic Care CKM \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Silver Simple Women's Health with Menopause Benefits \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
AIAN Cost Share	Tier 5 - Specialty	✓	—	✓	PA \| QL
AIAN Cost Share \| with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL

UnitedHealthcare

17 plans

Source: PDF · Formulary date: Sep 23, 2026 · Checked: 23 hours, 50 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL
UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 5 - Specialty	✓	—	✓	PA \| QL