Nemluvio

Generic: nemolizumab-ilto

30 MG — Pen Injector

DERMATOLOGICALS

Also known as: nemolizumab-ilto

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Advantage 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Care 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Value 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Local 2026 Tier 5 - Specialty ✓ — ✓ Restricted Access; Limited Distribution PA | QL
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 4 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 2 per 28 days PA | QL
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 2 per 28 days PA | QL
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 2 per 28 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 2 per 28 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic ✓ — ✓ 2 per 28 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 2 per 28 days PA | QL
Senior Care (HMO I-SNP) Tier 5 - Specialty ✓ — ✓ 2 per 28 days PA | QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred ✓ — — PA
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