FYAVOLV .005/1 mg Tablet, Film Coated
Also known as Norethindrone Acetate And Ethinyl Estradiol. Coverage in Delaware, DC and Maryland (CMS PDP Region 05).
4 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 3–4.
No plan applies a prior authorization, step therapy or quantity limit.
57 Medicare Advantage plans in DE, DC, MD do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. DE: 23 plans · DC: 10 plans · MD: 24 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $1.0867 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $2.0011 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $2.3907 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $2.3907 | — | 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.