testosterone undecanoate
100 mg, 112.5 mg, 150 mg, 158 mg, 198 mg, 200 mg, 237 mg — Capsule
Also known as:
JATENZO
KYZATREX
TLANDO
UNDECATREX
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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.
Blue Cross Blue Shield Federal
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Basic Option 2026
via Jatenzo |
Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Jatenzo |
Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via Kyzatrex |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Kyzatrex |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Tlando |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Tlando |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Tlando |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Kyzatrex |
Not Covered | — | — | — | None |