Trelegy Ellipta

Generic: fluticasone- umeclidinium-vilanterol aepb 100-62.5-25 mcg/act, 200-62.5-25 mcg/act

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Advantage 2026	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Care 2026	Tier 3 - High Cost Brand	—	—	✓	QL
BCBSNC Blue Value 2026	Tier 3 - High Cost Brand	—	—	✓	QL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 2 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Unknown	—	—	✓	QL