Do I have to choose the zebra ball point refills or could I use a 0.7 gel ink refill for the pen?

The Moleskine Pen+ Ellipse uses a 4C cartridge size, so as long as the size is the same, you can use any size tip or ink you desire!

I was told you can use any paper, is that true?

The innovation behind the Moleskine Pen+ Ellipse is best experienced through the carefully thought out ecosystem of Smart Paper Tablets and the Moleskine app. Moleskine Pen+ Ellipse digitizes your notes in real time by working in conjunction with special ncoded paper which is found in the Smart Paper Tablets and the Moleskine App. Without this ecosystem the pen won't be able to translate your handwritten notes from analog to digital.

Moleskine Ellipse +Pen:- how do you change the refill?

The refill tip can be pulled out of the pen and replaced with any 4C zebra refill. Refills: https://www.amazon.com/Zebra-0-7mm-4C-Pen-Refill/dp/B003VVZX66/ref=sr_1_5?crid=1DAZRA8A29MA9&keywords=zebra+4c-0.7+pen+refill&qid=1579886662&rnid=2470954011&sprefix=4c+zebra%2Caps%2C152&sr=8-5

Can this pen work with any notebook?

Sure--the pen will write on any paper. Nut if you want it to work the Moleskine Magic-you've gotta use one of their Smart pads

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Specifications

Manufacturer	Moleskine
Brand	Moleskine
Item Weight	0.002 ounces
Product Dimensions	2.28 x 1.1 x 5.71 inches
Item model number	KAWBALLPENBK
Color	Black
Closure	Twist
Grip Type	Smooth
Material Type	Plastic
Number of Items	1
Size	1 Count (Pack of 1)
Point Type	ball tip
Line Size	1.0mm
Ink Color	Blue
Manufacturer Part Number	KAWBALLPENBK