sub-q insulin delivery

20 unit — Device

INSULINS

Also known as: sub-q insulin delivery device, 20 unit,disposable sub-q insulin delivery device, 30 unit, disposable sub-q insulin delivery device, 40 unit, disposable V-GO 20 V-GO 30 V-GO 40

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 15 hours, 11 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary PA
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