Cetrorelix

0.25 Mg — Vial

Gonadotropin Releasing Hormone Receptor Antagonist

Also known as: Cetrorelix 0.25 Mg Vial

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 17 hours, 4 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Cetrotide
Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 17 hours, 4 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026
via Cetrotide
Tier 5 - Non-Preferred Specialty PA
BCBS Federal Standard Option 2026
via Cetrotide
Tier 5 - Non-Preferred Specialty PA
Something not right?