levonorgestrel/ethinyl estradiol/iron

0.1 mg-0.02 mg (21)/iron (7) — Tablet

Also known as: LEVONORG-ETH ESTRAD-FE BISGLYC JOYEAUX MINZOYA BALCOLTRA

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

8 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 55 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Basic Option 2026 via joyeaux	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Focus 2026 via minzoya	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Focus 2026 via joyeaux	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Standard Option 2026 via minzoya	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Basic Option 2026 via minzoya	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Standard Option 2026 via joyeaux	Tier 1 - Generic	—	—	— NCTM	None
BCBS Federal Standard Option 2026 via Balcoltra	Tier 3 - Non-Preferred Brand	—	—	—	None
BCBS Federal Basic Option 2026 via Balcoltra	Tier 3 - Non-Preferred Brand	—	—	—	None

9 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026 via minzoya	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via joyeaux	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via joyeaux	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - HDHP 2026 via joyeaux	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via minzoya	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via minzoya	Tier 0 - $0 Copay (ACA Preventive)	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Balcoltra	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Balcoltra	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Balcoltra	Not Covered	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 20 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None

2 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 20 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via joyeaux	Tier 1 - $0 Copay Preventive	—	—	—	None
UnitedHealthcare NC Individual & Family 2026 via minzoya	Tier 1 - $0 Copay Preventive	—	—	—	None