dasetta
Generic: Norethindrone-Ethinyl Estradiol
35 MG — Tablet
COMBINATION CONTRACEPTIVES - ORAL
Also known as:
dasetta tab 1/35
dasetta tab 7/7/7
Dasetta Tab 1/35
Dasetta Tab 7/7/7
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
40 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via nylia |
Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield Federal
12 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via nylia |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via nortrel |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via alyacen |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via nylia |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via alyacen |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via nortrel |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via nylia |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via alyacen |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via nortrel |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
Cigna
80 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Silver 4400 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Silver
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via nortrel |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Silver
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 4400 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 5000 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3000 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 6500 Indiv Med Deductible
via nylia |
Tier 1 - Preferred Generic | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver 3500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Silver
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 2200 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Gold 1500 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect myDiabetesCare Bronze
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 5500 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 6000 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver 3500 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze RD 5000 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Silver RD 3500 Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via alyacen |
Tier 1 - Preferred Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via alyacen |
Tier 2 - Generic | — | — | — | None |
| Connect Bronze CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Gold CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 2 - Generic | — | — | — | None |
| Connect Silver CMS Standard | Tier 2 - Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via nylia |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold RD CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
Connect Bronze RD CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
Connect Gold CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver RD CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
|
Connect Silver CMS Standard
via nortrel |
Tier 2 - Generic | — | — | — | None |
NC Medicaid PDL
1 planNC State Health Plan
12 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via nylia |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via nylia |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via nylia |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via nortrel |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via nortrel |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via nortrel |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via alyacen |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via alyacen |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via alyacen |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |