Norethindrone-Ethinyl Estradiol

1 mg-35 mcg, 1 mg-35 mcg (21) — Tablet

Estrogen Agents, Combinations

Also known as: FemHRT Norethindrone-Ethinyl Estradiol 1 Mg-5 Mcg Tablet Norethindrone-Ethinyl Estradiol 1.5-0.03 Mg (21) Tablet Norethindrone-Ethinyl Estradiol 1-0.02 Mg Tablet NYLIA NORTREL ALYACEN DASETTA
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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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via nylia 		Tier 1 - Generic — — — NCTM None
BCBS Federal Focus 2026
via dasetta 		Tier 1 - Generic — — — NCTM None
BCBS Federal Focus 2026
via nortrel 		Tier 1 - Generic — — — NCTM None
BCBS Federal Standard Option 2026
via alyacen 		Tier 1 - Generic — — — NCTM None
BCBS Federal Standard Option 2026
via dasetta 		Tier 1 - Generic — — — NCTM None
BCBS Federal Standard Option 2026
via nortrel 		Tier 1 - Generic — — — NCTM None
BCBS Federal Standard Option 2026
via nylia 		Tier 1 - Generic — — — NCTM None
BCBS Federal Basic Option 2026
via alyacen 		Tier 1 - Generic — — — NCTM None
BCBS Federal Basic Option 2026
via dasetta 		Tier 1 - Generic — — — NCTM None
BCBS Federal Basic Option 2026
via nortrel 		Tier 1 - Generic — — — NCTM None
BCBS Federal Basic Option 2026
via nylia 		Tier 1 - Generic — — — NCTM None
BCBS Federal Focus 2026
via alyacen 		Tier 1 - Generic — — — NCTM None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 20 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 1 - Generic — — — None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred — — — None
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 nylia 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via alyacen 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via alyacen 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - HDHP 2026
via alyacen 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via dasetta 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via dasetta 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - HDHP 2026
via dasetta 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via nortrel 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via nortrel 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - HDHP 2026
via nortrel 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via nylia 		Tier 0 - $0 Copay (ACA Preventive) — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via nylia 		Tier 0 - $0 Copay (ACA Preventive) — — — None
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 1 - Basic Core Formulary — — — None
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