Does Blue Cross® Premier PPO Gold Extra cover immunoglobulin G?
Blue Cross® Premier PPO Gold Extra
15560-15560MI1130002-0 · ACA · ACA Marketplace
immunoglobulin G
immunoglobulin Gunder Blue Cross® Premier PPO Gold Extra
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
45%of the price your plan negotiates
Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. From the first fill — no deductible on this drug.
This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.
- Tier
- Preferred specialty
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (41)
- 10 ML immune globulin subcutaneous (human) - hipp 165 MG/ML Injection [Cutaquig]
- 10 ML immune globulin subcutaneous (human) - klhw 200 MG/ML Injection [Xembify]
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gammaked]
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 10 ML immunoglobulin G, human 200 MG/ML Injection [Cuvitru]
- 10 ML immunoglobulin G, human 200 MG/ML Injection [Hizentra]
- 10 ML immunoglobulin G, human 200 MG/ML Prefilled Syringe [Hizentra]
- 100 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard ERC]
- 100 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 100 ML immunoglobulin G, human 100 MG/ML Injection [Gammaked]
- 100 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 12 ML immune globulin subcutaneous (human) - hipp 165 MG/ML Injection [Cutaquig]
- 20 ML immune globulin subcutaneous (human) - hipp 165 MG/ML Injection [Cutaquig]
- 20 ML immune globulin subcutaneous (human) - klhw 200 MG/ML Injection [Xembify]
- 20 ML immunoglobulin G, human 200 MG/ML Injection [Cuvitru]
- 20 ML immunoglobulin G, human 200 MG/ML Injection [Hizentra]
- 20 ML immunoglobulin G, human 200 MG/ML Prefilled Syringe [Hizentra]
- 200 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 200 ML immunoglobulin G, human 100 MG/ML Injection [Gammaked]
- 200 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 24 ML immune globulin subcutaneous (human) - hipp 165 MG/ML Injection [Cutaquig]
- 25 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 25 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 300 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 40 ML immunoglobulin G, human 200 MG/ML Injection [Cuvitru]
- 400 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 48 ML immune globulin subcutaneous (human) - hipp 165 MG/ML Injection [Cutaquig]
- 5 ML immune globulin subcutaneous (human) - klhw 200 MG/ML Injection [Xembify]
- 5 ML immunoglobulin G, human 200 MG/ML Injection [Cuvitru]
- 5 ML immunoglobulin G, human 200 MG/ML Injection [Hizentra]
- 5 ML immunoglobulin G, human 200 MG/ML Prefilled Syringe [Hizentra]
- 50 ML immune globulin subcutaneous (human) - klhw 200 MG/ML Injection [Xembify]
- 50 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard ERC]
- 50 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard]
- 50 ML immunoglobulin G, human 100 MG/ML Injection [Gammaked]
- 50 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex]
- 50 ML immunoglobulin G, human 200 MG/ML Injection [Cuvitru]
- 50 ML immunoglobulin G, human 200 MG/ML Injection [Hizentra]
- 50 ML immunoglobulin G, human 200 MG/ML Prefilled Syringe [Hizentra]