drospiren-eth estrad-levomefol

0.451 MG — Tablet

Also known as: Drospiren-Eth Estrad-Levomefol Oral Tablet

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 15 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Bronze Signature + No Referrals 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 Essential + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic None
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 2 - Generic None
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