Ella

Generic: ulipristal acetate

30 MG — Tablet

CONTRACEPTIVES

Also known as: ELLA TABS 30MG ulipristal acetate Ella 30 Mg Tablet

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  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Expanded Bronze with Atrium Health Tier 0 - $0 Preventive None
Standard Silver with Atrium Health Tier 0 - $0 Preventive None
Standard Gold with Atrium Health Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold + Vision + Adult Dental Tier 0 - $0 Preventive None
Everyday Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Elite Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Expanded Bronze + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Silver + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Gold + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Everyday Bronze with Atrium Health Tier 0 - $0 Preventive None
Elite Bronze with Atrium Health Tier 0 - $0 Preventive None
Focused Silver with Atrium Health Tier 0 - $0 Preventive None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive None
Complete Gold Tier 0 - $0 Preventive None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 0 - $0 Preventive None
Everyday Bronze Tier 0 - $0 Preventive None
Elite Bronze Tier 0 - $0 Preventive None
Clear Silver with $0 Insulin Options Tier 0 - $0 Preventive None
Standard Expanded Bronze Tier 0 - $0 Preventive None
Standard Silver Tier 0 - $0 Preventive None
Standard Gold Tier 0 - $0 Preventive None
Complete Gold with Atrium Health Tier 0 - $0 Preventive None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand NCTM None
BCBS Federal Basic Option 2026 Tier 2 - Preferred Brand NCTM None
BCBS Federal Standard Option 2026 Tier 2 - Preferred Brand NCTM None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Value 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Advantage 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Local 2026 Tier A - ACA $0 Copay None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Tier 0 - $0 Copay (ACA Preventive) None
NC State Health Plan - HDHP 2026 Tier 0 - $0 Copay (ACA Preventive) None
NC State Health Plan - 80/20 Plus PPO 2026 Tier 0 - $0 Copay (ACA Preventive) None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via ulipristal acetate
Tier 1 - Basic Core Formulary PA | ST
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 25 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026 Unknown QL
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