tri-mili
Generic: Norgestimate-Ethinyl Estradiol
Tablet
COMBINATION CONTRACEPTIVES - ORAL
Also known as:
tri-mili tab
Tri-Mili Tab
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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.
Blue Cross Blue Shield Federal
24 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via Tri-Sprintec |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via Estarylla |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via Mili |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via mono-linyah |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via TRI-LINYAH |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via tri-vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Focus 2026
via vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via Estarylla |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via Mili |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via mono-linyah |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via TRI-LINYAH |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via Tri-Sprintec |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via tri-vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Standard Option 2026
via vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via Estarylla |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via Mili |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via mono-linyah |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via TRI-LINYAH |
Tier 1 - Generic | — | — | — NCTM | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via Tri-Sprintec |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via tri-vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
|
BCBS Federal Basic Option 2026
via vylibra |
Tier 1 - Generic | — | — | — NCTM | None |
Cigna
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Cigna Plus NC 4-Tier Formulary 2026
via Tri-Sprintec |
Tier 1 - Generic | — | — | — | None |
|
Cigna Plus NC 4-Tier Formulary 2026
via TRI-LINYAH |
Tier 1 - Generic | — | — | — | None |
|
Cigna Plus NC 4-Tier Formulary 2026
via Tri-Estarylla |
Tier 1 - Generic | — | — | — | None |
|
Cigna Plus NC 4-Tier Formulary 2026
via Norgestimate-Ethinyl Estradiol |
Tier 1 - Generic | — | — | — | None |
|
Cigna Plus NC 4-Tier Formulary 2026
via Mili |
Tier 1 - Generic | — | — | — | None |
|
Cigna Plus NC 4-Tier Formulary 2026
via Estarylla |
Tier 1 - Generic | — | — | — | None |
NC State Health Plan
24 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Tri-Sprintec |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Tri-Sprintec |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Tri-Sprintec |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via tri-vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via tri-vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via tri-vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via vylibra |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Estarylla |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Estarylla |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Estarylla |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Mili |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Mili |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Mili |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via mono-linyah |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via mono-linyah |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via mono-linyah |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via TRI-LINYAH |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via TRI-LINYAH |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via TRI-LINYAH |
Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 0 - $0 Copay (ACA Preventive) | — | — | — | None |
TRICARE
1 planUnitedHealthcare
7 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
UnitedHealthcare NC Individual & Family 2026
via vylibra |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via tri-vylibra |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via Tri-Sprintec |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via TRI-LINYAH |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via Tri-Estarylla |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via mono-linyah |
Tier 1 - $0 Copay Preventive | — | — | — | None |
|
UnitedHealthcare NC Individual & Family 2026
via Estarylla |
Tier 1 - $0 Copay Preventive | — | — | — | None |