{24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack

Verify with CMS →

ethinyl estradiol

RxCUI: 1426600

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
46.2%
Plan Coverage
2,340
Plans Covering
T2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack

Per the CMS 2026 Part D formulary file, {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack (RxNorm concept RXCUI 1426600, generic name ethinyl estradiol) appears on 77 distinct formulary files spanning 2,340 Medicare Part D plan offerings - 46.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.

Real-world access to {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack today.

Coverage Details

Formularies covering
77
Plans covering
2,340
Coverage rate
46.2%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

29 plans
Tier 1, Preferred Generic
71 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T1 No $0 OR
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) ELDERPLAN, INC. T1 No $44.80 NY
MetroPlus Platinum Plan (HMO) METROPLUS HEALTH PLAN, INC. T1 No $58.80 NY
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T2 No $0 CA
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 KY
Aetna Medicare HIDE (HMO D-SNP) AETNA HEALTH OF OHIO INC. T2 No $0 KY
Aetna Medicare Dual Care (HMO D-SNP) AETNA HEALTH OF OHIO INC. T2 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T2 No $0 OH

Frequently Asked Questions

Is {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack covered by Medicare Part D?

Yes, {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack is covered by 2,340 Medicare Part D plans (46.2% of all Part D formularies).

What tier is {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack on Medicare Part D plans?

{24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.

Does {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack require prior authorization?

0% of Part D formularies require prior authorization for {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack. Step therapy: 0%. Quantity limits: 0%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial