Ulticare

Generic: /needle (disp)

0.3 Ml, 29G — Prefilled Syringe

Also known as: Ulticare Syringe/Low Dead Ulticare Pen Needle 29G 12.7Mm Ulticare Pen Needle 29G 12Mm Ulticare Pen Needle 31G 3/16" Ulticare Pen Needle 31G 6Mm Ulticare Pen Needle 31G 8Mm Ulticare Pen Needle 32G 4Mm Ulticare Pen Needle 32G 6Mm Ulticare Syringe 0.3 Ml 29G 1/2" Ulticare Syringe 0.3 Ml 30G 1/2" Ulticare Syringe 0.3 Ml 30G 5/16" Ulticare Syringe 0.3 Ml 31G 5/16" Ulticare Syringe 0.5 Ml 28G 1/2" Ulticare Syringe 0.5 Ml 29G 1/2" Ulticare Syringe 0.5 Ml 30G 1/2" Ulticare Syringe 0.5 Ml 30G 5/16" Ulticare Syringe 0.5 Ml 31G 5/16" Ulticare Syringe 1 Ml 30G 1/2" Ulticare Syringe 1 Ml 30G 5/16" Ulticare Syringe 1 Ml 31G 5/16"

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Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

Blue Cross Blue Shield of NC

240 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 41 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Integra	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Luer-Lok	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Plastipak	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Eclipse Needle/Luer-Lo	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Safetyglide	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Bd Slip Tip	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint Safety 1St Syri	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Carepoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Caretouch Luer Lock	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Crono	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fliplock Safet	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flipl	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Flu T	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Sheat	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Fluringe Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easy Touch Sheathlock Saf	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Easypoint Needle/Syringe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Blunt	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Lifeshield Syrin	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Monoject Magellan	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Securesafe	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Hypodermic Safety	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/10Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/21G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/22G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/23G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/3Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Lock/5Ml/20G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/25G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/26G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringe/Luer Slip/1Ml/27G	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/1Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/10Ml/2	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/20	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/21	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Lock/5Ml/22	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Syringes/Luer Slip/1Ml/25	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Verisafe Safety Sterile S	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Advantage 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Vanishpoint Safety Syring	Tier 3 - High Cost Brand	—	—	—	None

Cigna

9 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 41 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Bd Eclipse	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Integra	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Luer-Lok	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Bd Safetyglide	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Easy Touch Safety	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Monoject	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Securesafe	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026	Tier 2 - Preferred Brand	—	—	—	None
Cigna Plus NC 4-Tier Formulary 2026 via Vanishpoint	Tier 2 - Preferred Brand	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 41 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Securesafe	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Securesafe	Not Covered	—	—	—	None