ganirelix acetate
Generic: Fyremadel
250mcg/0.5ml — Prefilled Syringe
Also known as:
ganirelix acetate soln prefilled syringe 250 mcg/0.5ml
ganirelix acetate sosy 250mcg/0.5ml
GANIRELIX ACETATE SOSY 250MCG/0.5ML
Ganirelix Acetate Subcutaneous Solution Prefilled Syringe
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
58 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
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 |
|
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 |
|
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
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 + Vision + Adult Dental
via Fyremadel |
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 |
| 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 |
| Standard Gold with Atrium Health + Vision + Adult Dental | 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 |
| 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 |
|
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 |
|
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 |
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
3 plans| 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 |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| 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 |
| BCBSNC Blue Value 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
| BCBSNC Blue Care 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
| BCBSNC Blue Advantage 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
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 |
|
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 |
UnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Gold Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |