norelgestromin-ethinyl estradiol td ptwk

Generic: norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr

CONTRACEPTIVES

Also known as: norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 1 hour, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 1 - Generic NCTM None
BCBS Federal Basic Option 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 1 - Generic NCTM None
BCBS Federal Focus 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 1 - Generic NCTM None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 1 hour, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Value 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Advantage 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier A - ACA $0 Copay None
BCBSNC Blue Local 2026 Tier A - ACA $0 Copay None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 1 hour, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 0 - $0 Copay (ACA Preventive) None
NC State Health Plan - 70/30 Standard PPO 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 0 - $0 Copay (ACA Preventive) None
NC State Health Plan - HDHP 2026
via norelgestromin-ethinyl estradiol td ptwk 150-35 mcg/24hr
Tier 0 - $0 Copay (ACA Preventive) None
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