Symlin

Generic: pramlintide acetate

1.5 MG, 2.7 MG — Pen Injector

Amylin Analog

Also known as: pramlintide acetate

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 16 hours, 50 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 4 - Non-Preferred None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 4 - Non-Preferred None
Source: CMS QHP JSON  ·  Checked: 16 hours, 49 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Simple PCP Saver Tier 4 - Non-Preferred ST
Gold Elite Saver Plus Tier 4 - Non-Preferred ST
Silver Simple Diabetes Tier 4 - Non-Preferred ST
Secure | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Classic 4700 | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 4 - Non-Preferred ST
Silver Classic | with Atrium Health Tier 4 - Non-Preferred ST
Silver Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred ST
Silver Simple PCP Saver | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Classic Standard Tier 4 - Non-Preferred ST
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Simple Diabetes | with Atrium Health Tier 4 - Non-Preferred ST
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 4 - Non-Preferred ST
Silver Simple Chronic Care CKM | with Atrium Health Tier 4 - Non-Preferred ST
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 4 - Non-Preferred ST
AIAN Cost Share Tier 4 - Non-Preferred ST
AIAN Cost Share | with Atrium Health Tier 4 - Non-Preferred ST
Gold Elite Saver Plus | with Atrium Health Tier 4 - Non-Preferred ST
Silver Classic Standard Tier 4 - Non-Preferred ST
Gold Classic Standard Tier 4 - Non-Preferred ST
Bronze Classic Standard | with Atrium Health Tier 4 - Non-Preferred ST
Silver Classic Standard | with Atrium Health Tier 4 - Non-Preferred ST
Gold Classic Standard | with Atrium Health Tier 4 - Non-Preferred ST
Bronze Elite + PCP Saver Plus Tier 4 - Non-Preferred ST
Silver Classic Tier 4 - Non-Preferred ST
Secure Tier 4 - Non-Preferred ST
Bronze Classic 4700 Tier 4 - Non-Preferred ST
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