FillMapCapital Blue Cross Classic (PPO)

Does Capital Blue Cross Classic (PPO) cover ethinyl estradiol / norethindrone / ferrous fumarate?

Capital Blue Cross Classic (PPO)
H3923-013-0 · MA_LOCAL · Medicare Part D
ethinyl estradiol / norethindrone / ferrous fumarate
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 / norethindrone / ferrous fumarateunder Capital Blue Cross Classic (PPO)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$47per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. Before that, you pay the full price until you have paid $100 this year.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Tier
Tier 3
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 (24)

  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Feirza 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey Fe 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin Fe 1/20]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Loestrin Fe 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Microgestin Fe 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tarina Fe 1/20 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 21 Fe 1.5/30 28 Day Pack]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Feirza 1.5/30 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 1.5/30 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin Fe 1.5/30]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Loestrin Fe 1.5/30 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Microgestin Fe 1.5/30 28 Day]Tier 3
  • {21 (ethinyl estradiol 0.035 MG / norethindrone 0.4 MG Chewable Tablet) / 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Wymzya Fe 28 Day]Tier 4
  • {21 (ethinyl estradiol 0.035 MG / norethindrone 0.4 MG Chewable Tablet) / 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Xelria Fe 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 24 Fe 1/20 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey 24 Fe 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 24 1/20 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tarina 24 FE 1/20 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]Tier 4
  • {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Kaitlib Fe 28 Day]Tier 4
  • {5 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ethinyl estradiol 0.03 MG / norethindrone acetate 1 MG Oral Tablet) / 9 (ethinyl estradiol 0.035 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tilia Fe]Tier 4
  • {5 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ethinyl estradiol 0.03 MG / norethindrone acetate 1 MG Oral Tablet) / 9 (ethinyl estradiol 0.035 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tri-Legest 28 Day]Tier 4
  • {5 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ethinyl estradiol 0.03 MG / norethindrone acetate 1 MG Oral Tablet) / 9 (ethinyl estradiol 0.035 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Xarah Fe 28 Day]Tier 4

← All coverage for ethinyl estradiol / norethindrone / ferrous fumarate