ulipristal acetate

Generic: Ella

30 mg — Tablet

CONTRACEPTIVE AGENTS

Also known as: ELLA
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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: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Complete Gold + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Everyday Bronze + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Elite Bronze + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Silver + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Gold + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health + Vision + Adult Dental
via Ella 		Tier 0 - $0 Preventive — — — None
Complete Gold
via Ella 		Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Ella 		Tier 0 - $0 Preventive — — — None
Everyday Bronze
via Ella 		Tier 0 - $0 Preventive — — — None
Elite Bronze
via Ella 		Tier 0 - $0 Preventive — — — None
Clear Silver with $0 Insulin Options
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Silver
via Ella 		Tier 0 - $0 Preventive — — — None
Standard Gold
via Ella 		Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health
via Ella 		Tier 0 - $0 Preventive — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Ella 		Tier 2 - Preferred Brand — — — NCTM None
BCBS Federal Basic Option 2026
via Ella 		Tier 2 - Preferred Brand — — — NCTM None
BCBS Federal Standard Option 2026
via Ella 		Tier 2 - Preferred Brand — — — NCTM None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026
via Ella 		Tier A - ACA $0 Copay — — — None
BCBSNC Blue Value 2026
via Ella 		Tier A - ACA $0 Copay — — — None
BCBSNC Blue Advantage 2026
via Ella 		Tier A - ACA $0 Copay — — — None
BCBSNC Blue Home with UNC Health Alliance 2026
via Ella 		Tier A - ACA $0 Copay — — — None
BCBSNC Blue Local 2026
via Ella 		Tier A - ACA $0 Copay — — — None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via Ella 		Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026
via Ella 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - HDHP 2026
via Ella 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Ella 		Tier 0 - $0 Copay (ACA Preventive) — — — None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 1 - Basic Core Formulary ✓ ✓ — PA | ST
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
via Ella 		Unknown — — ✓ QL
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