peginterferon beta-1a
Generic: Plegridy
125 mcg/0.5 mL, 63 mcg/0.5 mL (1)-94 mcg/0.5 mL (1) — Prefilled Syringe
Also known as:
PLEGRIDY
PLEGRIDY PEN
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Clear Silver with $0 Insulin Options
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold with Atrium Health
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold + Vision + Adult Dental
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Plegridy |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Plegridy |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Plegridy |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Plegridy Starter Pack |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Advantage 2026
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Plegridy Starter Pack |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Local 2026
via Plegridy Starter Pack |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Plegridy Starter Pack |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Plegridy Starter Pack |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
Medicare Part D
14 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Plegridy |
Tier 1 - Preferred Generic | — | — | ✓ 1 per 28 days | QL |
|
Longevity Health Plan (HMO I-SNP)
via Plegridy |
Tier 1 - Preferred Generic | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via Plegridy |
Tier 1 - Preferred Generic | — | — | ✓ 1 per 28 days | QL |
|
NHC Advantage (HMO I-SNP)
via Plegridy |
Tier 1 - Preferred Generic | — | — | ✓ 1 per 28 days | QL |
|
PruittHealth Premier (HMO I-SNP)
via Plegridy |
Tier 1 - Preferred Generic | — | — | ✓ 1 per 28 days | QL |
|
Senior Care (HMO I-SNP)
via Plegridy |
Tier 5 - Specialty | — | — | ✓ 1 per 28 days | QL |
|
Blue Medicare Essential Plus (HMO-POS)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Blue Medicare Enhanced (HMO-POS)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Blue Medicare Choice (HMO)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Blue Medicare Essential (HMO)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Experience Health Medicare Advantage (HMO)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via Plegridy |
Tier 5 - Specialty | — | — | ✓ 1 per 28 days | QL |
|
Blue Medicare PPO Enhanced (PPO)
via Plegridy |
Tier 5 - Specialty | ✓ | — | ✓ 1 per 28 days | PA | QL |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Plegridy |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Plegridy |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Plegridy |
Tier 6 - Non-Preferred Brand Specialty | ✓ | — | ✓ | PA | QL |
TRICARE
1 planUnitedHealthcare
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UnitedHealthcare NC Individual & Family 2026
via Plegridy |
Unknown | ✓ | — | ✓ | PA | QL |
|
UnitedHealthcare NC Individual & Family 2026
via Plegridy Starter Pack |
Unknown | ✓ | — | ✓ | PA | QL |