MedicarePartD.guide

A non-government resource built from CMS public data

LOESTRIN FE 28 DAY Kit

Also known as Norethindrone Acetate And Ethinyl Estradiol And Ferrous Fumarate. Coverage in Idaho and Utah (CMS PDP Region 31).

4 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 2–3.

Lowest 30-day cost $0.00 at a preferred pharmacy. No plan applies a prior authorization, step therapy or quantity limit.

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 4 of 4 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$8.5034—None
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible2Generic$0.00$0.00$8.5034—None
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible · $0 with full Extra Help2Generic$10.00$30.00$0.6546—None
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible2Generic$4.00$0.00$8.5034—None

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

Medicare Advantage plans

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.

57 Medicare Advantage plans in ID, UT do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. ID: 25 plans · UT: 32 plans.

See coverage in all 39 regions →