Menopur
Generic: menotropins for subcutaneous
75 UNIT — Solution
Also known as:
follicle stimulating hormone
Menopur Subcutaneous Solution Reconstituted
Follicle Stimulating Hormone
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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 + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Advantage 2026 | Tier 4 - Higher Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 4 - Higher Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Local 2026 | Tier 4 - Higher Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Care 2026 | Tier 4 - Higher Cost Brand | — | — | ✓ | QL |
| BCBSNC Blue Value 2026 | Tier 4 - Higher Cost Brand | — | — | ✓ | QL |
UnitedHealthcare
13 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| UHC Silver Value ($0 Virtual Urgent Care, 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 Silver Value + ($0 Virtual Urgent Care, 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 Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Standard+ Dental + Vision (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, No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Bronze Essential ($0 Virtual Urgent Care, 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 Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |
| UHC Silver Standard (No Referrals) | Tier 5 - Specialty | ✓ | — | — | PA |