Novarel

Generic: Chorionic Gonadotropin

Injection

Also known as: Chorionic Gonadotropin
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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: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Expanded Bronze with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold with Atrium Health + Vision + Adult Dental
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Expanded Bronze
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Silver
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Standard Gold
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Checked: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via chorionic gonadotropin 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Jun 1, 2026  ·  Checked: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026
via Pregnyl 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Pregnyl 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Local 2026
via Pregnyl 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Care 2026
via Pregnyl 		Tier 3 - High Cost Brand — — ✓ QL
BCBSNC Blue Value 2026
via Pregnyl 		Tier 3 - High Cost Brand — — ✓ QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze RD CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold RD CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD CMS Standard
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3000 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Bronze
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 4400 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect myDiabetesCare Silver
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Gold 1500 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver 3500 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible
via chorionic gonadotropin 		Tier 4 - Non-Preferred ✓ — — PA
Source: CMS QHP JSON  ·  Checked: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Simple Diabetes | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple Chronic Care CKM | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AIAN Cost Share
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
AIAN Cost Share | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Classic Standard
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Gold Classic Standard
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Classic Standard | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Gold Classic Standard | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Classic
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Secure
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Secure | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Classic | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus | with Atrium Health
via Pregnyl 		Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Bronze Standard (No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Gold Standard (No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Silver Standard (No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Pregnyl 		Tier 4 - Non-Preferred ✓ — — PA
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