Tri-Lo-Sprintec

Tablet

Also known as: Tri-Lo-Sprintec Tablet

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 16 hours, 5 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 16 hours, 5 minutes ago

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