drospirenone/estetrol

3 mg-14.2 mg (28) — Tablet

CONTRACEPTIVE AGENTS

Also known as: NEXTSTELLIS

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Nextstellis
Tier 2 - Preferred Brand — — — NCTM None
BCBS Federal Standard Option 2026
via Nextstellis
Tier 2 - Preferred Brand — — — NCTM None
BCBS Federal Basic Option 2026
via Nextstellis
Tier 2 - Preferred Brand — — — NCTM None
Source: PDF  ·  Formulary date: Oct 7, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze 6500 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze 5500 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver 5000 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver 3600 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver 3000 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Gold CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect myDiabetesCare Bronze
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect myDiabetesCare Silver
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Gold 1500 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze RD CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver RD 3500 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver RD 5000 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver RD 2200 Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Silver RD CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Gold RD CMS Standard
via Nextstellis
Tier 4 - Non-Preferred — — — None
Connect Bronze 7000 HSA Indiv Med Deductible
via Nextstellis
Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 3 hours, 23 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Nextstellis
Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Nextstellis
Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - HDHP 2026
via Nextstellis
Tier 0 - $0 Copay (ACA Preventive) — — — None
Source: Excel (XLSX)  ·  Formulary date: Jul 31, 2026  ·  Checked: 3 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
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