Yupelri

Generic: revefenacin

175MCG/3ML — Solution

Orally Inhaled Anticholinergics / Copd Agents

Also known as: revefenacin YUPELRI SOLN 175MCG/3ML
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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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand — — — None
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 17 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthTeam Advantage Plan I (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthTeam Advantage Plan II (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthTeam Advantage Vitality Plan (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring True Choice (PPO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Select (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty ✓ — ✓ 90 per 30 days PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 17 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026 Tier 2 - Non-Preferred Generic — — — None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 2 - Non-Preferred Generic — — — None
NC State Health Plan - 80/20 Plus PPO 2026 Tier 2 - Non-Preferred Generic — — — None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 17 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via revefenacin 		Tier 3 - Non-Formulary ✓ — — PA
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