Does Aetna Medicare Chronic Care Value (HMO C-SNP) cover ethinyl estradiol / levonorgestrel?
Aetna Medicare Chronic Care Value (HMO C-SNP)
H3146-044-0 · MA_LOCAL · Medicare Part D
ethinyl estradiol / levonorgestrel
Do you get help with your Medicare drug costs?None of these
Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.
ethinyl estradiol / levonorgestrelunder Aetna Medicare Chronic Care Value (HMO C-SNP)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$5per 30-day fill
Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.
This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.
- Tier
- Tier 2
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.
Covered forms and strengths (8)
- {28 (ethinyl estradiol 0.02 MG / levonorgestrel 0.09 MG Oral Tablet) } PackTier 2
- {28 (ethinyl estradiol 0.02 MG / levonorgestrel 0.09 MG Oral Tablet) } Pack [Dolishale 28 Day]Tier 2
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 42 (ethinyl estradiol 0.02 MG / levonorgestrel 0.15 MG Oral Tablet) / 21 (ethinyl estradiol 0.025 MG / levonorgestrel 0.15 MG Oral Tablet) / 21 (ethinyl estradiol 0.03 MG / levonorgestrel 0.15 MG Oral Tablet) } Pack [Rosyrah 91 Day]Tier 2
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 84 (ethinyl estradiol 0.02 MG / levonorgestrel 0.1 MG Oral Tablet) } PackTier 2
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 84 (ethinyl estradiol 0.02 MG / levonorgestrel 0.1 MG Oral Tablet) } Pack [CamreseLo 91 Day]Tier 3
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 84 (ethinyl estradiol 0.02 MG / levonorgestrel 0.1 MG Oral Tablet) } Pack [Lojaimiess 91 Day]Tier 2
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 84 (ethinyl estradiol 0.03 MG / levonorgestrel 0.15 MG Oral Tablet) } Pack [Ashlyna 91 Day]Tier 2
- {7 (ethinyl estradiol 0.01 MG Oral Tablet) / 84 (ethinyl estradiol 0.03 MG / levonorgestrel 0.15 MG Oral Tablet) } Pack [Jaimiess 91 Day]Tier 2