Miudella

Generic: copper

Copper-containing Intrauterine Device

Also known as: copper
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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.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 hours, 11 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via ParaGard 		Tier 0 - $0 Preventive — — — None
Everyday Bronze
via ParaGard 		Tier 0 - $0 Preventive — — — None
Elite Bronze
via ParaGard 		Tier 0 - $0 Preventive — — — None
Clear Silver with $0 Insulin Options
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Silver
via ParaGard 		Tier 0 - $0 Preventive — — — None
Complete Gold
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Gold
via ParaGard 		Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Complete Gold + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Silver + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Gold + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Complete Gold Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 0 - $0 Preventive — — — None
Everyday Bronze Tier 0 - $0 Preventive — — — None
Elite Bronze Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Complete Gold + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Everyday Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Everyday Bronze + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Elite Bronze + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via ParaGard 		Tier 0 - $0 Preventive — — — None
Clear Silver with $0 Insulin Options Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze Tier 0 - $0 Preventive — — — None
Standard Silver Tier 0 - $0 Preventive — — — None
Standard Gold Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health Tier 0 - $0 Preventive — — — None
Elite Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Silver + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Gold + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 hours, 11 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver 3500 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Silver
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Silver RD 2200 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Gold 1500 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Bronze
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Bronze 5500 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Silver RD 3500 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Silver 4400 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Silver RD 5000 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Silver 3000 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect Bronze 6500 Indiv Med Deductible
via ParaGard 		Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Silver Tier 1 - Preferred Generic — — — None
Connect Silver RD 2200 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Gold 1500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Bronze Tier 1 - Preferred Generic — — — None
Connect Bronze 5500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze RD 6000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver 3500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver RD 3500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver 4400 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver 3000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze 6500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Gold CMS Standard Tier 2 - Generic — — — None
Connect Silver CMS Standard Tier 2 - Generic — — — None
Connect Silver RD CMS Standard Tier 2 - Generic — — — None
Connect Bronze RD CMS Standard Tier 2 - Generic — — — None
Connect Silver CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Silver RD CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Gold CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Bronze RD CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Gold RD CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Bronze CMS Standard
via ParaGard 		Tier 2 - Generic — — — None
Connect Gold RD CMS Standard Tier 2 - Generic — — — None
Connect Bronze CMS Standard Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 13 hours, 11 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Copper 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Copper 		Tier 3 - Non-Preferred Brand — — — None
NC State Health Plan - HDHP 2026
via Copper 		Tier 3 - Non-Preferred Brand — — — None
Source: CMS QHP JSON  ·  Checked: 13 hours, 11 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Classic Standard
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Gold Classic Standard
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Classic Standard | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Classic Standard | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Gold Classic Standard | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Elite + PCP Saver Plus
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Classic
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Secure
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Classic 4700
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple PCP Saver
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Gold Elite Saver Plus
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple Diabetes
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Classic 4700 | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Secure | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Elite + PCP Saver Plus | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Classic | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple Diabetes | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple PCP Saver | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Gold Elite Saver Plus | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Simple Chronic Care CKM | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Simple Diabetes | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple Chronic Care CKM | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
AIAN Cost Share
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
AIAN Cost Share | with Atrium Health
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
Bronze Classic Standard
via ParaGard 		Tier 0 - $0 Preventive — — ✓ QL
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