Nova Max Plus Ketone Test

Generic: ketone blood test strip

Test Strip

MEDICAL DEVICES

Also known as: NOVA MAX TES GLUCOSE

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: Apr 1, 2026  ·  Checked: 7 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026
via Gojji Blood Ketone Test S
Tier 4 - Higher Cost Brand None
BCBSNC Blue Home with UNC Health Alliance 2026
via Gojji Blood Ketone Test S
Tier 4 - Higher Cost Brand None
BCBSNC Blue Local 2026
via Gojji Blood Ketone Test S
Tier 4 - Higher Cost Brand None
BCBSNC Blue Care 2026
via Gojji Blood Ketone Test S
Tier 4 - Higher Cost Brand None
BCBSNC Blue Value 2026
via Gojji Blood Ketone Test S
Tier 4 - Higher Cost Brand None
BCBSNC Blue Advantage 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Local 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Care 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Value 2026 Tier 4 - Higher Cost Brand None
BCBSNC Blue Advantage 2026
via Fora Gtel Blood Ketone Te
Tier 4 - Higher Cost Brand None
BCBSNC Blue Home with UNC Health Alliance 2026
via Fora Gtel Blood Ketone Te
Tier 4 - Higher Cost Brand None
BCBSNC Blue Local 2026
via Fora Gtel Blood Ketone Te
Tier 4 - Higher Cost Brand None
BCBSNC Blue Care 2026
via Fora Gtel Blood Ketone Te
Tier 4 - Higher Cost Brand None
BCBSNC Blue Value 2026
via Fora Gtel Blood Ketone Te
Tier 4 - Higher Cost Brand None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 7 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Gojji Blood Ketone Test S
Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026
via Gojji Blood Ketone Test S
Not Covered None
NC State Health Plan - HDHP 2026
via Gojji Blood Ketone Test S
Not Covered None
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
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