Ultiguard Safepack

0.3 Ml, 30G — Prefilled Syringe

Also known as: Ultiguard Safepack 29G 12.7Mm Ultiguard Safepack Syringe 0.3 Ml 30G 12.7Mm Ultiguard Safepack Syringe 0.3 Ml 31G 8Mm Ultiguard Safepack Syringe 0.5 Ml 30G 12.7Mm Ultiguard Safepack Syringe 0.5 Ml 31G 8Mm Ultiguard Safepack Syringe 1 Ml 30G 12.7Mm Ultiguard Safepack Syringe 1 Ml 31G 8Mm

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: Jan 1, 2026  ·  Checked: 19 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect myDiabetesCare Silver Tier 3 - Preferred Brand None
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand None
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand None
Connect Silver CMS Standard Tier 3 - Preferred Brand None
Connect Silver RD CMS Standard Tier 3 - Preferred Brand None
Connect Gold CMS Standard Tier 3 - Preferred Brand None
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand None
Connect Gold RD CMS Standard Tier 3 - Preferred Brand None
Connect Bronze CMS Standard Tier 3 - Preferred Brand None
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