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levonorgestrel and ethinyl estradiol Medicare Coverage in Pennsylvania

100%
of plans in Pennsylvania
cover levonorgestrel and ethinyl estradiol
253 of 253 plans
$0.81
Avg 30-day copay in Pennsylvania
30
Plans shown below

Medicare Plans Covering levonorgestrel and ethinyl estradiol in Pennsylvania

Sorted by lowest 30-day copay at a preferred pharmacy. Prices shown are estimates from CMS formulary data.

Plan Name Monthly Premium Tier 30-day Copay Stars Restrictions
UPMC for Life PPO Essential Care Rx (PPO) Lowest Copay $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Complete Blue PPO Signature (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Aetna Medicare Advantra Prime Plus (HMO-POS) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Aetna Medicare Signature Extra (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Geisinger Gold Secure Rx (HMO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Community Blue Medicare HMO Distinct (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana Gold Plus H6622-054 (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Community Blue Medicare HMO Signature (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage Essentials from UHC PA-5 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Jefferson Health Plans Giveback (HMO) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
UPMC for Life HMO Premier Rx (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Community Blue Medicare HMO Signature (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Aetna Medicare Advantra Signature Giveback (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Geisinger Gold Classic Essential Rx (HMO) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Complete Blue HMO Distinct (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana Gold Choice H8145-052 (PFFS) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Complete Blue PPO Signature (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Wellcare Simple (HMO-POS) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Provider Partners Pennsylvania Community Plan (HMO I-SNP) $0.00/mo Tier 1 - Preferred Generic $0.00 N/A None Details →
HumanaChoice H5525-051 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Community Blue Medicare HMO Signature (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Aetna Medicare Advantra Dual Care (HMO D-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
UHC Complete Care PA-17 (HMO-POS C-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Jefferson Health Plans Dual Pearl (HMO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Together Blue Medicare HMO Signature (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Aetna Medicare Signature Giveback (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) $0.00/mo Tier 1 - Preferred Generic $0.00 N/A None Details →
Perennial Advantage Freedom (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Jefferson Health Plans Flex (PPO) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →

Compare All Pennsylvania Plans for levonorgestrel and ethinyl estradiol

Enter your exact ZIP code to see plans available in your specific county, ranked by total annual cost.

Frequently Asked Questions

100% of Medicare Part D plans in Pennsylvania cover levonorgestrel and ethinyl estradiol. There are 30 plans available. Coverage and costs vary by specific plan.

The average 30-day copay for levonorgestrel and ethinyl estradiol in Pennsylvania is $0.81 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.

Based on current CMS data, UPMC for Life PPO Essential Care Rx (PPO) offers one of the lowest copays for levonorgestrel and ethinyl estradiol in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.

View national coverage data for levonorgestrel and ethinyl estradiol

levonorgestrel and ethinyl estradiol Coverage in Other States

Click any state to see the plans and costs available there.

Alabama 100% avg $1.23/mo Arizona 100% avg $0.68/mo Arkansas 100% avg $1.00/mo California 100% avg $0.37/mo Colorado 100% avg $0.53/mo Connecticut 100% avg $0.82/mo Delaware 100% avg $2.40/mo District of Columbia 100% avg $1.60/mo Florida 100% avg $0.39/mo Georgia 100% avg $0.65/mo Hawaii 100% — Idaho 100% — Illinois 100% avg $0.38/mo Indiana 100% avg $1.53/mo Iowa 100% — Kansas 100% avg $0.17/mo Kentucky 100% avg $0.51/mo Louisiana 100% avg $7.43/mo Maine 100% — Maryland 100% avg $0.56/mo Massachusetts 100% — Michigan 100% avg $5.42/mo Minnesota 100% avg $1.86/mo Mississippi 100% avg $0.54/mo Missouri 100% avg $0.55/mo Montana 100% — Nebraska 100% — Nevada 100% avg $0.69/mo New Hampshire 100% — New Jersey 100% avg $1.00/mo New Mexico 100% avg $0.47/mo New York 100% avg $1.77/mo North Carolina 100% avg $0.49/mo North Dakota 100% — Ohio 100% avg $3.21/mo Oklahoma 100% avg $1.36/mo Oregon 100% avg $0.92/mo Puerto Rico 100% — Rhode Island 100% — South Carolina 100% avg $0.43/mo South Dakota 100% — Tennessee 100% avg $2.92/mo Texas 100% avg $0.52/mo Utah 100% avg $0.51/mo Vermont 100% — Virginia 100% avg $0.08/mo Washington 100% avg $0.09/mo West Virginia 100% avg $1.75/mo Wisconsin 100% avg $1.39/mo Wyoming 100% —

Coverage data from CMS formulary files for plan year 2026. How we calculate costs • National coverage for levonorgestrel and ethinyl estradiol

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