ganirelix acetate

Generic: Fyremadel

250mcg/0.5ml — Prefilled Syringe

OXYTOCICS

Also known as: ganirelix acetate soln prefilled syringe 250 mcg/0.5ml ganirelix acetate sosy 250mcg/0.5ml GANIRELIX ACETATE SOSY 250MCG/0.5ML

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: 3 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Silver with Atrium Health Tier 5 - Specialty PA
Standard Gold with Atrium Health Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 5 - Specialty PA
Complete Gold + Vision + Adult Dental Tier 5 - Specialty PA
Everyday Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Elite Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Focused Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Complete Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Standard Silver + Vision + Adult Dental Tier 5 - Specialty PA
Standard Gold + Vision + Adult Dental Tier 5 - Specialty PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Complete Gold
via Fyremadel
Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Fyremadel
Tier 5 - Specialty PA
Everyday Bronze
via Fyremadel
Tier 5 - Specialty PA
Elite Bronze
via Fyremadel
Tier 5 - Specialty PA
Clear Silver with $0 Insulin Options
via Fyremadel
Tier 5 - Specialty PA
Standard Expanded Bronze
via Fyremadel
Tier 5 - Specialty PA
Standard Silver
via Fyremadel
Tier 5 - Specialty PA
Standard Gold with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Complete Gold + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Everyday Bronze + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Elite Bronze + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Elite Bronze with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Focused Silver with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Complete Gold with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Expanded Bronze + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Silver + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Gold + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Silver with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Gold with Atrium Health + Vision + Adult Dental
via Fyremadel
Tier 5 - Specialty PA
Standard Gold
via Fyremadel
Tier 5 - Specialty PA
Everyday Bronze with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Elite Bronze with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Focused Silver with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Complete Gold with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Standard Expanded Bronze with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Standard Silver with Atrium Health
via Fyremadel
Tier 5 - Specialty PA
Elite Bronze Tier 5 - Specialty PA
Clear Silver with $0 Insulin Options Tier 5 - Specialty PA
Standard Expanded Bronze Tier 5 - Specialty PA
Standard Silver Tier 5 - Specialty PA
Standard Gold Tier 5 - Specialty PA
Complete Gold Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 5 - Specialty PA
Everyday Bronze Tier 5 - Specialty PA
Everyday Bronze with Atrium Health Tier 5 - Specialty PA
Elite Bronze with Atrium Health Tier 5 - Specialty PA
Focused Silver with Atrium Health Tier 5 - Specialty PA
Complete Gold with Atrium Health Tier 5 - Specialty PA
Standard Expanded Bronze with Atrium Health Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 2 - Preferred Brand PA
BCBS Federal Standard Option 2026 Tier 4 - Preferred Specialty PA
BCBS Federal Basic Option 2026 Tier 4 - Preferred Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand QL
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand QL
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand QL
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via fyremadel sosy
Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026
via fyremadel sosy
Not Covered None
NC State Health Plan - HDHP 2026
via fyremadel sosy
Not Covered None
NC State Health Plan - 80/20 Plus PPO 2026
via Ganirelix Acetate Sosy
Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026
via Ganirelix Acetate Sosy
Not Covered None
NC State Health Plan - HDHP 2026
via Ganirelix Acetate Sosy
Not Covered None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 3 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026 Unknown PA
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