Ganirelix Acetate Sosy
Generic: ganirelix acetate
250MCG/0.5ML
Gonadotropin Releasing Hormone Receptor Antagonist
Also known as:
GANIRELIX ACETATE SOSY 250MCG/0.5ML
ganirelix acetate sosy 250mcg/0.5ml
Compare Prices
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 |
|---|---|---|---|---|---|
|
Standard Gold with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via ganirelix acetate |
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
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Clear Silver with $0 Insulin Options
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Everyday Bronze with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Elite Bronze with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Focused Silver with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Complete Gold with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Expanded Bronze with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Silver with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Standard Gold with Atrium Health
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via ganirelix acetate |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via ganirelix acetate |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via ganirelix acetate |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via ganirelix acetate |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Care 2026
via ganirelix acetate |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Value 2026
via ganirelix acetate |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Advantage 2026
via ganirelix acetate |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via ganirelix acetate |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
|
BCBSNC Blue Local 2026
via ganirelix acetate |
Tier 2 - Medium Cost Generic/Brand | — | — | ✓ | QL |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Not Covered | — | — | — | None |