drospirenone/ethinyl estradiol/levomefolate calcium
3 mg-0.02 mg-0.451 mg (24)/0.451 mg (4), 3 mg-0.03 mg-0.451 mg (21)/0.451 mg (7) — Tablet
Also known as:
SAFYRAL
DROSPIRENONE-ETH ESTRA-LEVOMEF
BEYAZ
TYDEMY
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Blue Cross Blue Shield Federal
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Basic Option 2026
via tydemy |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via tydemy |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via tydemy |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via Safyral |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
BCBS Federal Basic Option 2026
via Safyral |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
BCBS Federal Basic Option 2026
via Beyaz |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
BCBS Federal Standard Option 2026
via Beyaz |
Tier 3 - Non-Preferred Brand | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Local 2026
via Beyaz |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Beyaz |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Care 2026
via Beyaz |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Value 2026
via Beyaz |
Tier A - ACA $0 Copay | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via Beyaz |
Tier A - ACA $0 Copay | — | — | — | None |
NC State Health Plan
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via tydemy |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via tydemy |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via tydemy |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Safyral |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Safyral |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Safyral |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Beyaz |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Beyaz |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Beyaz |
Not Covered | — | — | — | None |