hailey fe

20 MG — Tablet

COMBINATION CONTRACEPTIVES - ORAL

Also known as: hailey fe tab 1.5/30 hailey fe tab 1/20 Hailey Fe Tab 1.5/30 Hailey Fe Tab 1/20

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  ·  Formulary date: Sep 22, 2026  ·  Checked: 15 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 15 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026 Tier 1 - Generic — — — NCTM None
BCBS Federal Focus 2026 Tier 1 - Generic — — — NCTM None
BCBS Federal Standard Option 2026 Tier 1 - Generic — — — NCTM None
Source: PDF  ·  Formulary date: Oct 7, 2026  ·  Checked: 15 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze 6500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver 3600 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Bronze Tier 1 - Preferred Generic — — — None
Connect Silver 5000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver 3000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Gold 1500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze RD 6000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver RD 3500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Silver RD 2200 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze 5500 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect myDiabetesCare Silver Tier 1 - Preferred Generic — — — None
Connect Bronze RD 5000 Indiv Med Deductible Tier 1 - Preferred Generic — — — None
Connect Bronze CMS Standard Tier 2 - Generic — — — None
Connect Silver RD CMS Standard Tier 2 - Generic — — — None
Connect Bronze RD CMS Standard Tier 2 - Generic — — — None
Connect Silver CMS Standard Tier 2 - Generic — — — None
Connect Gold CMS Standard Tier 2 - Generic — — — None
Connect Gold RD CMS Standard Tier 2 - Generic — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 15 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 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 - 70/30 Standard PPO 2026 Tier 0 - $0 Copay (ACA Preventive) — — — None
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