Natazia 28 Day

Generic: dienogest

2 MG — Tablet

Progestin

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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: Jan 1, 2026  ·  Checked: 17 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Everyday Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Elite Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Silver + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Gold + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Standard Silver with Atrium Health Tier 0 - $0 Preventive — — — None
Standard Gold with Atrium Health Tier 0 - $0 Preventive — — — None
Everyday Bronze Tier 0 - $0 Preventive — — — None
Elite Bronze Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 0 - $0 Preventive — — — None
Clear Silver with $0 Insulin Options Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze Tier 0 - $0 Preventive — — — None
Standard Silver Tier 0 - $0 Preventive — — — None
Standard Gold Tier 0 - $0 Preventive — — — None
Everyday Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Elite Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Complete Gold Tier 0 - $0 Preventive — — — None
Focused Silver with Atrium Health Tier 0 - $0 Preventive — — — None
Complete Gold with Atrium Health Tier 0 - $0 Preventive — — — None
Standard Expanded Bronze with Atrium Health Tier 0 - $0 Preventive — — — None
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 0 - $0 Preventive — — — None
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 17 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
HumanaChoice H5525-050 (PPO) Tier 4 - Non-Preferred — — — None
HumanaChoice H5525-049 (PPO) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H1036-137 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H1036-233 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Dual Select H1036-307 (HMO D-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Plus Giveback H1036-318 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H1036-335 (HMO-POS) Tier 4 - Non-Preferred — — — None
HumanaChoice Giveback H5216-017 (PPO) Tier 4 - Non-Preferred — — — None
HumanaChoice H5216-211 (PPO) Tier 4 - Non-Preferred — — — None
Humana Full Access H5525-034 (PPO) Tier 4 - Non-Preferred — — — None
HumanaChoice Giveback H5525-035 (PPO) Tier 4 - Non-Preferred — — — None
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Choice H8145-004 (PFFS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H6622-061 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H6622-060 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H6622-057 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Dual Select H6622-027 (HMO-POS D-SNP) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H6622-026 (HMO-POS) Tier 4 - Non-Preferred — — — None
Humana Gold Plus H6622-025 (HMO-POS) Tier 4 - Non-Preferred — — — None
HumanaChoice H5525-083 (PPO) Tier 4 - Non-Preferred — — — None
Humana Dual Select H5525-072 (PPO D-SNP) Tier 4 - Non-Preferred — — — None
HumanaChoice H5525-070 (PPO) Tier 4 - Non-Preferred — — — None
Source: CMS QHP JSON  ·  Checked: 17 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Classic | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Classic Standard Tier 0 - $0 Preventive — — — None
Silver Classic Standard Tier 0 - $0 Preventive — — — None
Gold Classic Standard Tier 0 - $0 Preventive — — — None
Bronze Classic Standard | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Classic Standard | with Atrium Health Tier 0 - $0 Preventive — — — None
Gold Classic Standard | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Elite + PCP Saver Plus Tier 0 - $0 Preventive — — — None
Silver Classic Tier 0 - $0 Preventive — — — None
Secure Tier 0 - $0 Preventive — — — None
Bronze Classic 4700 Tier 0 - $0 Preventive — — — None
Silver Simple PCP Saver Tier 0 - $0 Preventive — — — None
Gold Elite Saver Plus Tier 0 - $0 Preventive — — — None
Silver Simple Diabetes Tier 0 - $0 Preventive — — — None
Secure | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Classic 4700 | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Simple Diabetes | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Simple PCP Saver | with Atrium Health Tier 0 - $0 Preventive — — — None
Gold Elite Saver Plus | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Simple Chronic Care CKM | with Atrium Health Tier 0 - $0 Preventive — — — None
Bronze Simple Diabetes | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Simple Chronic Care CKM | with Atrium Health Tier 0 - $0 Preventive — — — None
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 0 - $0 Preventive — — — None
AIAN Cost Share Tier 0 - $0 Preventive — — — None
AIAN Cost Share | with Atrium Health Tier 0 - $0 Preventive — — — None
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 17 hours, 10 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Gold Standard (No Referrals) Tier 0 - $0 Preventive — — — None
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Bronze Standard+ Dental + Vision (No Referrals) Tier 0 - $0 Preventive — — — None
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Bronze Standard (No Referrals) Tier 0 - $0 Preventive — — — None
UHC Silver Value ($0 Virtual Urgent Care, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Silver Standard (No Referrals) Tier 0 - $0 Preventive — — — None
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals Tier 0 - $0 Preventive — — — None
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) Tier 0 - $0 Preventive — — — None
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) Tier 0 - $0 Preventive — — — None
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