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levonorgestrel and ethinyl estradiol Medicare Part D Coverage

Dosage form
KIT
84%
of Medicare Part D plans
cover levonorgestrel and ethinyl estradiol
4,647 of 5,530 plans
2.3
Avg. formulary tier
$15.00
Median 30-day copay
$0.00–$30.00
Copay range

Formulary Tier Distribution

How Medicare Part D plans classify levonorgestrel and ethinyl estradiol. Lower tiers = lower copays.

Tier 1 - Preferred Generic 6%
277 plans • avg $0.00/mo
Tier 2 - Generic 63%
2,941 plans • avg $1.89/mo
Tier 3 - Preferred Brand 28%
1,282 plans • avg $1.16/mo
Tier 4 - Non-Preferred Drug 3%
147 plans • avg $2.70/mo

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levonorgestrel and ethinyl estradiol Medicare Coverage by State

Coverage rates and average costs vary significantly by state. Click a state to see the specific plans available there.

Frequently Asked Questions about levonorgestrel and ethinyl estradiol

84% of Medicare Part D plans cover levonorgestrel and ethinyl estradiol. It is most commonly placed on Tier 2. Coverage varies by plan and geographic area.

The median 30-day copay for levonorgestrel and ethinyl estradiol on Medicare Part D is $15.00 at a preferred pharmacy. Costs range from $0.00 to $30.00 depending on the plan.

levonorgestrel and ethinyl estradiol is placed on Tier 2 by most Medicare Part D plans. Lower tier numbers generally mean lower copays.

0% of plans require prior authorization for levonorgestrel and ethinyl estradiol. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →