Gonal-F Rff Rediject Sopn 300Unt/0.48Ml, 450Unt/0.72Ml, 900Unt/1.44Ml

0.48ML

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 11 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 5 - Non-Preferred Specialty	—	—	—	None
BCBS Federal Basic Option 2026	Tier 5 - Non-Preferred Specialty	—	—	—	None