{24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]
ethinyl estradiol
RxCUI: 2704559
What the CMS Formulary Data Shows for {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]
Per the CMS 2026 Part D formulary file, {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] (RxNorm concept RXCUI 2704559, generic name ethinyl estradiol) appears on 88 distinct formulary files spanning 2,216 Medicare Part D plan offerings - 43.7% 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 2.3.
Real-world access to {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] 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 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] today.
Coverage Details
- Formularies covering
- 88
- Plans covering
- 2,216
- Coverage rate
- 43.7%
- 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
Medicare Advantage Plans (MA-PD) Covering {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]
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 |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| 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 |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| 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 |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| 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 |
Frequently Asked Questions
Is {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] covered by Medicare Part D?
Yes, {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] is covered by 2,216 Medicare Part D plans (43.7% of all Part D formularies).
What tier is {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] on Medicare Part D plans?
{24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day] require prior authorization?
0% of Part D formularies require prior authorization for {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.