Does Devoted C-SNP Choice Premium 009 Ok (PPO C-SNP) cover ethinyl estradiol / norethindrone?
Devoted C-SNP Choice Premium 009 Ok (PPO C-SNP)
H2845-009-0 · MA_LOCAL · Medicare Part D
ethinyl estradiol / norethindrone
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 / norethindroneunder Devoted C-SNP Choice Premium 009 Ok (PPO C-SNP)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$19per 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 $615 this year.
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 (17)
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } PackTier 2
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Junel 1/20 21 Day]Tier 2
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Larin 1/20]Tier 2
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Loestrin 1/20 21 Day]Tier 2
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Luizza 1/20 21 Day]Tier 2
- {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Microgestin 1/20 21 Day]Tier 2
- {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Junel 1.5/30 21 Day]Tier 2
- {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Larin 1.5/30]Tier 2
- {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Loestrin 1.5/30 21 Day]Tier 2
- {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Luizza 1.5/30 21 Day]Tier 2
- {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Microgestin 1.5/30 21 Day]Tier 2
- {21 (ethinyl estradiol 0.035 MG / norethindrone 1 MG Oral Tablet) } Pack [Nortrel 1/35 21 Day]Tier 2
- {28 (ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet) } PackTier 3
- {28 (ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet) } PackTier 3
- ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet [Fyavolv]Tier 3
- ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet [Fyavolv]Tier 3
- ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet [Jinteli]Tier 3