milnacipran HCl

100 mg, 12.5 mg, 12.5 mg (5)-25 mg (8)-50 mg (42), 25 mg, 50 mg — Tablet

ANTIDEPRESSANTS AND NON-OPIOID PAIN SYNDROME AGENTS

Also known as: SAVELLA
GoodRx Compare Prices

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Elite Bronze with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Focused Silver with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Complete Gold with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Everyday Bronze
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Elite Bronze
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Expanded Bronze
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Silver
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Silver with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Gold with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Gold + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Silver + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Expanded Bronze + Vision + Adult Dental
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Complete Gold
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Standard Gold
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health
via Savella 		Tier 3 - Preferred Brand ✓ — ✓ PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via Savella 		Tier 3 - Non-Preferred Brand — — ✓ QL
BCBS Federal Basic Option 2026
via Savella 		Tier 3 - Non-Preferred Brand — — ✓ QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026
via Savella 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Savella 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Value 2026
via Savella Titration Pack 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Local 2026
via Savella 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Care 2026
via Savella 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Value 2026
via Savella 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Advantage 2026
via Savella Titration Pack 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Savella Titration Pack 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Local 2026
via Savella Titration Pack 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
BCBSNC Blue Care 2026
via Savella Titration Pack 		Tier 3 - High Cost Brand — — ✓ Restricted Access QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via Savella Titration Pack 		Tier 3 - Non-Preferred — — — None
Cigna Plus NC 4-Tier Formulary 2026
via Savella 		Tier 3 - Non-Preferred — — — None
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Savella 		Tier 1 - Preferred Generic — — ✓ 60 per 30 days QL
Longevity Health Plan (HMO I-SNP)
via Savella 		Tier 1 - Preferred Generic — — ✓ 60 per 30 days QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Savella 		Tier 1 - Preferred Generic — — ✓ 60 per 30 days QL
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Savella 		Tier 1 - Preferred Generic — — ✓ 60 per 30 days QL
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Signature (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Guardian (HMO-POS I-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Freedom (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Liberty (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S001 (PPO D-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-S2 (PPO D-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0001 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0004 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0016 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0017 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0019 (PPO)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-25 (HMO-POS C-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-27 (HMO-POS C-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
UHC Complete Care NC-28 (HMO-POS C-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
Erickson Advantage Champion (HMO-POS C-SNP)
via Savella 		Tier 3 - Preferred Brand — — — None
Wellcare Simple Open (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Simple (HMO-POS)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Giveback Open (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Plan I (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Plan II (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Vitality Plan (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Dual Liberty Open (PPO D-SNP)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Assist Open (PPO)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Dual Access (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Dual Liberty (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Wellcare Dual Reserve (HMO-POS D-SNP)
via Savella 		Tier 3 - Preferred Brand — — ✓ 60 per 30 days QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Savella 		Tier 4 - Non-Preferred — ✓ — ST
Troy Medicare (HMO)
via Savella 		Tier 4 - Non-Preferred — ✓ — ST
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Savella 		Tier 4 - Non-Preferred — ✓ ✓ 60 per 30 days ST | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via Savella 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Savella 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - HDHP 2026
via Savella 		Tier 3 - Non-Preferred Brand — — — None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
via Savella Titration Pack 		Unknown — ✓ ✓ ST | QL
UnitedHealthcare NC Individual & Family 2026
via Savella 		Unknown — ✓ ✓ ST | QL
Something not right?