{24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day]
ethinyl estradiol
RxCUI: 1037185
What the CMS Formulary Data Shows for {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day]
Per the CMS 2026 Part D formulary file, {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] (RxNorm concept RXCUI 1037185, generic name ethinyl estradiol) appears on 11 distinct formulary files spanning 44 Medicare Part D plan offerings - 0.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.6.
Real-world access to {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 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 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 44
- Coverage rate
- 0.9%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 4, Non-Preferred
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 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day]
44 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| FHCP Medicare Classic (HMO) | FLORIDA BLUE MEDICARE, INC. | T3 | No | $0 | FL |
| FHCP Medicare Rx Plus (HMO-POS) | FLORIDA BLUE MEDICARE, INC. | T3 | No | $49.00 | FL |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T4 | No | $0 | MS |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T4 | No | $0 | OR |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Independent Health's Assure Advantage (HMO C-SNP) | INDEPENDENT HEALTH ASSOCIATION, INC. | T4 | No | $46.50 | NY |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| Independent Health's Medicare Family Choice (HMO I-SNP) | INDEPENDENT HEALTH ASSOCIATION, INC. | T4 | No | $58.80 | NY |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $86.40 | NY |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $135.00 | NY |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $146.00 | NY |
| Independent Health's Encompass 65 RED 043 (HMO) | INDEPENDENT HEALTH ASSOCIATION, INC. | T4 | No | $190.00 | NY |
Frequently Asked Questions
Is {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] covered by Medicare Part D?
Yes, {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] is covered by 44 Medicare Part D plans (0.9% of all Part D formularies).
What tier is {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] on Medicare Part D plans?
{24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] averages Tier 3.6 across Part D plans, ranging from Tier 2 to Tier 4.
Does {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day] require prior authorization?
0% of Part D formularies require prior authorization for {24 (ethinyl estradiol 0.01 MG / norethindrone acetate 1 MG Oral Tablet) / 2 (ethinyl estradiol 0.01 MG Oral Tablet) / 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day]. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.