Incruse Ellipta
Generic: umeclidinium br aero powd breath act 62.5 mcg/act (base eq)
62.5 Mcg — Inhaler
Also known as:
Incruse Ellipta 62.5 Mcg Inhaler
Incruse Ellipta Inhalation Aerosol Powder Breath Activated
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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.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
| AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Brand-Preferred | — | — | ✓ | QL |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Care 2026 | Tier 3 - High Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Local 2026 | Tier 3 - High Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 3 - High Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Value 2026 | Tier 3 - High Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Advantage 2026 | Tier 3 - High Cost Brand | — | — | ✓ | QL |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Gold RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 5000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Gold CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 3600 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 3 - Preferred Brand | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 3 - Preferred Brand | — | — | — | None |