etonogestrel-ethinyl estradiol

Generic: etonogestrel/ethinyl estradiol

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 14 hours, 17 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via etonogestrel/ethinyl estradiol	Tier 1 - Basic Core Formulary	—	—	—	None