Relion Confirm-micro

Generic: blood sugar diagnostic

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SELF MONITORING BLOOD GLUCOSE SYSTEMS

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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 15, 2026  ·  Checked: 4 hours, 30 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver RD 2200 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze 5500 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver 3000 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Bronze
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver 3600 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Gold 1500 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Silver
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Gold RD CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Gold CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Gold CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Gold RD CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver RD CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze CMS Standard
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Gold CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Gold RD CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver RD CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze CMS Standard
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver RD CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze CMS Standard
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver 3000 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Bronze
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Gold 1500 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze 5500 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 5000 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver 3600 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Silver
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver 5000 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 2200 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Bronze 6500 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 3500 Indiv Med Deductible
via Easymax 		Tier 3 - Preferred Brand — — — None
Connect Silver 3000 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Bronze
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Gold 1500 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze 5500 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 5000 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver 3600 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver 5000 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Silver
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 3500 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver 5000 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 2200 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze 6500 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Silver RD 3500 Indiv Med Deductible
via Embrace 		Tier 3 - Preferred Brand — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Connect Bronze 6500 Indiv Med Deductible
via True Metrix Glucose Test Strip 		Tier 3 - Preferred Brand — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 4 hours, 30 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Agamatrix 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Agamatrix 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - HDHP 2026
via Agamatrix 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Caresens N 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Caresens N 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Caresens N 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Diatrue Plus 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Diatrue Plus 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Diatrue Plus 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Plus Ii 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Plus Ii 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easy Plus Ii 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Step 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Step 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easy Step 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Talk 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Talk 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easy Talk 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easy Trak 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easy Trak 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easy Trak 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easymax 15 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easymax 15 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easymax 15 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Easymax 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Easymax 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Easymax 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Embrace 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Embrace 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Embrace 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora D15G 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora D15G 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora D15G 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora D20 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora D20 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora D20 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora G20 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora G20 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora G20 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V10 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V10 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora V10 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V12 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V12 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora V12 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V20 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V20 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora V20 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Fora V30A 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Fora V30A 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Fora V30A 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Microdot 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Microdot 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Microdot 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Quintet Ac 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Quintet Ac 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Quintet Ac 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Unistrip1 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Unistrip1 		Not Covered — — — None
NC State Health Plan - HDHP 2026
via Unistrip1 		Not Covered — — — None
Source: Excel (XLSX)  ·  Formulary date: Sep 23, 2026  ·  Checked: 4 hours, 30 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via Telcare 		Tier 2 - Brand Formulary ✓ — ✓ SELECT LANCETS TO BE DISP AT MAX QTY OF 204 UNITS IN 22 DAYS OR 612 UNITS IN 68 DAYS PA | QL PA on 1 of 2 NDCs: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Embrace 		Tier 2 - Brand Formulary ✓ — ✓ SELECT SYRINGES,NEEDLES,SUPPLIES TO BE DISPENSED AT MAX QTY OF 200 UNITS IN 22D OR 600 UNITS IN 68D PA | QL PA on 2 of 10 NDCs: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Precision Xtra 		Tier 2 - Brand Formulary (Basic Core) — — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN QL Quantity limit
TRICARE Uniform Formulary 2026
via Fora Gtel Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fora Tn'g Advan Pro Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora Tn'g Voice Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora V10 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora V12 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora V20 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fora V30A 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Foracare GD20 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Foracare GD40 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Freestyle Insulinx 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Freestyle Insulinx Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Freestyle Precision Neo 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via GE100 Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via GE333 Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Genstrip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Gluco Navii 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Glucocard 01 Sensor Plus 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Glucocard Expression 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Glucocard Shine 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Glucocard Vital 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Glucocard Vital Sensor 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Glucocom Glucose 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Gojji Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Harmony Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Healthpro Glucose Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Ihealth Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via INFINITY TEST STRIPS 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Micro 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Microdot 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Microdot Xtra 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Mobi Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Myglucohealth 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Neutek 2TEK Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Nova Max Glucose Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via On Call Express Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via On Call Plus Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via On Call Vivid Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Onetouch Ultra Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Onetouch Verio Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Optium Ez 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Optumrx 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Pharmacist Choice 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Pip Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Platinum Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Precision Point Of Care 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Premier Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Premium Blood Glucose Test 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Premium V10 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Pro Voice V8-V9 Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Prodigy No Coding 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Quintet 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Quintet Ac 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Refuah Plus 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Relion Prime Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Reveal Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Rightest GS100 Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Rightest GS300 Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Rightest GS550 Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Rightest GT333 Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Smart Sense Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Smartest Test 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Solus V2 Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Sure-test Easyplus Mini 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Test N'go 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via True Metrix Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via True Metrix Pro Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Trueness Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Truetest Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Truetrack Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Ultima 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Ultratrak 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Ultratrak Ultimate 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Unistrip1 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Vivaguard Ino Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Precision Q-i-d 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fortiscare G1 Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fortiscare Glucose Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora D40-G31 Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora D20 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fora D15G 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fora 6CONN-GTEL-TN'G Adv Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora 6 Connect Glucose Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Ez Smart Plus 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Ez Smart 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Evolution Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Evencare Proview Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Evencare Mini Glucose Test Str 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Evencare G3 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Evencare G2 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Embrace Wave Glucose Test Strp 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Embrace Talk Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Embrace Pro Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Embrace Evo 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Element Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Element Compact 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Easymax 15 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Easymax 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Easygluco Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Easy Trak Ii Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Easy Trak 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Easy Touch Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 1 of 4 NDCs
TRICARE Uniform Formulary 2026
via Easy Touch Blulink Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Easy Talk Plus Ii 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Easy Talk 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Easy Step 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Easy Plus Ii 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Diatrue Plus 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Contour Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Contour Plus Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Contour Next Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 3 of 5 NDCs
TRICARE Uniform Formulary 2026
via Clever Choice Voice+ Tst Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Clever Choice Test Strips 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Clever Choice Talk 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Clever Choice Pro 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Clever Choice Micro Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Caretouch Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Caresens S Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora G20 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Blulink Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Blood Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 11 of 20 NDCs
TRICARE Uniform Formulary 2026
via Assure Titanium Test Strip 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit on 1 of 4 NDCs
TRICARE Uniform Formulary 2026
via Assure Prism Multi 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Assure Platinum Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Assure Platinum 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Assure 4 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Agamatrix Presto 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Agamatrix Jazz Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Agamatrix 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Advocate Redi-code+ 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Advanced Glucose Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Advanced Glucose Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Accutrend Glucose 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Accu-chek Smartview 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Accu-chek Guide Test Strip 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Accu-chek Aviva Plus 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Caresens N 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
TRICARE Uniform Formulary 2026
via Fora G30-PREMIUM V10 Test Strp 		Tier 3 - Non-Formulary ✓ — ✓ SEL TEST STRIPS TO DISP AT MAX OF 100 UNITS IN 22D OR 300 UNITS IN 68D W/O QF IN 365D OR RX BY OBGYN PA | QL PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION; Quantity limit
TRICARE Uniform Formulary 2026
via Fora GD50 Test Strips 		Tier 3 - Non-Formulary ✓ — — PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION
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