NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL Kit
Also known as Norethindrone Acetate And Ethinyl Estradiol Tablets And Ferrous Fumarate Tablets. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).
5 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 2–4.
Lowest 30-day cost $10.00 at a preferred pharmacy. No plan applies a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 5 of 5 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible · $0 with full Extra Help | 2Generic | $10.00 | $30.00 | $0.2953 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $0.4293 | — | None |
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $1.3958 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $0.7039 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $0.3698 | — | 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.
98 Medicare Advantage plans in PA, WV do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. PA: 83 plans · WV: 15 plans.