FillMapBSW Prime Silver HMO 005

Does BSW Prime Silver HMO 005 cover ethinyl estradiol / norethindrone / ferrous fumarate?

BSW Prime Silver HMO 005
40788-40788TX0460005-0 · ACA · ACA Marketplace
ethinyl estradiol / norethindrone / ferrous fumarate
ethinyl estradiol / norethindrone / ferrous fumarateunder BSW Prime Silver HMO 005
Covered — requires step therapy
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 (30)

  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } PackTry another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 1/20 28 Day]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 21 Fe 1/20 28 Day Pack]Try another first
  • {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]Try another first
  • {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]Try another first
  • {21 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin Fe 1/20]Try another first
  • {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]Try another first
  • {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]Try another first
  • {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]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } PackTry another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 1.5/30 28 Day]Try another first
  • {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]Try another first
  • {21 (ethinyl estradiol 0.03 MG / norethindrone acetate 1.5 MG Oral Tablet) / 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey Fe 1.5/30 28 Day]Try another first
  • {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]Try another first
  • {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]Try another first
  • {21 (ethinyl estradiol 0.035 MG / norethindrone 0.4 MG Chewable Tablet) / 7 (ferrous fumarate 75 MG Chewable Tablet) } PackTry another first
  • {21 (ethinyl estradiol 0.035 MG / norethindrone 0.4 MG Chewable Tablet) / 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Wymzya Fe 28 Day]Try another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } PackTry another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Charlotte 24 Fe Chewable 28 Day]Try another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Finzala 24 Fe Chewable 28 Day]Try another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Mibelas 24 Fe Chewable 28 Day]Try another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 24 1/20 28 Day]Try another first
  • {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]Try another first
  • {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]Try another first
  • {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]Try another first
  • {24 (ethinyl estradiol 0.02 MG / norethindrone acetate 1 MG Oral Tablet) / 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin 24 Fe 1/20]Try another first
  • {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]Try another first
  • {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } PackTry another first
  • {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Kaitlib Fe 28 Day]Try another first
  • {24 (ethinyl estradiol 0.025 MG / norethindrone 0.8 MG Chewable Tablet) / 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Layolis Fe 28]Try another first

← All coverage for ethinyl estradiol / norethindrone / ferrous fumarate