V-Go 40

Generic: -q insulin delivery

Kit

Also known as: V-GO 40 KIT

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

9 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 7 hours, 37 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via V-Go 20	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Standard Option 2026 via V-Go 30	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Standard Option 2026	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Basic Option 2026 via V-Go 20	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Basic Option 2026 via V-Go 30	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Basic Option 2026	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Focus 2026 via V-Go 20	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Focus 2026 via V-Go 30	Tier 2 - Preferred Brand	✓	—	—	PA
BCBS Federal Focus 2026	Tier 2 - Preferred Brand	✓	—	—	PA

9 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 7 hours, 37 minutes ago

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