FillMapBSW Diabetes Care Gold HMO 014

Does BSW Diabetes Care Gold HMO 014 cover ethinyl estradiol / norethindrone?

BSW Diabetes Care Gold HMO 014
40788-40788TX0460014-0 · ACA · ACA Marketplace
ethinyl estradiol / norethindrone
ethinyl estradiol / norethindroneunder BSW Diabetes Care Gold HMO 014
Covered — some forms require step therapy
14 of 20 covered forms have a condition attached. You may need to try a cheaper medication first — your doctor’s office handles it.
What you'd pay
$20per 30-day fill

From the first fill — no deductible on this drug.

This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.

Tier
Generic
Approval first
Not needed
Try another first
Required
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 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.

Covered forms and strengths (20)

  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } PackTry another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Aurovela 1/20 21 Day]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Junel 1/20 21 Day]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Larin 1/20]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Loestrin 1/20 21 Day]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) } Pack [Microgestin 1/20 21 Day]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } PackTry another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Aurovela 1.5/30 21 Day]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Hailey 1.5/30 21 Day]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Junel 1.5/30 21 Day]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Larin 1.5/30]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Loestrin 1.5/30 21 Day]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) } Pack [Microgestin 1.5/30 21 Day]Try another first
  • {21 (ethinyl estradiol 0.035 MG / norethindrone 1 MG Oral Tablet) } Pack [Nortrel 1/35 21 Day]Try another first
  • {28 (ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack
  • {28 (ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet) } Pack
  • ethinyl estradiol 0.0025 MG / norethindrone acetate 0.5 MG Oral Tablet [Fyavolv]
  • ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet
  • ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet [Fyavolv]
  • ethinyl estradiol 0.005 MG / norethindrone acetate 1 MG Oral Tablet [Jinteli]

← All coverage for ethinyl estradiol / norethindrone