Zegalogue

Generic: dasiglucagon

6MG/0.6ML — Auto-Injector

Also known as: dasiglucagon ZEGALOGUE SOAJ .6MG/0.6ML Zegalogue Syringe

Coverage by Insurer

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

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 19 hours, 48 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None

UnitedHealthcare

13 plans

Source: PDF · Formulary date: Sep 23, 2026 · Checked: 19 hours, 48 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UHC Bronze Essential ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Gold Copay Focus $0 Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Bronze Standard (HSA, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Silver Standard ($8 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Silver Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Bronze Standard+ (HSA, $0 Insulin, Dental + Vision, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Gold Standard ($5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals)	Tier 0 - $0 Preventive	—	—	✓	QL