Medicare Part D coverage · 1250 · RxCUI 2619685
1250 MG estradiol 0.001 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, 1250 MG estradiol 0.001 MG/MG Topical Gel is covered by 451 Medicare Part D plans (8.9% of enrollable products), averaging Tier 3.6, with prior authorization required on 0% of covering formularies.
- 8.9%
- Plan coverage
- 451
- Plans covering
- T3.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 1250 MG estradiol 0.001 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, 1250 MG estradiol 0.001 MG/MG Topical Gel (RxNorm concept RXCUI 2619685, generic name 1250) appears on 76 distinct formulary files spanning 451 Medicare Part D plan offerings - 8.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.6.
Real-world access to 1250 MG estradiol 0.001 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 2.6% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1250 MG estradiol 0.001 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 76
- Plans covering
- 451
- Coverage rate
- 8.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 2.6% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1250 MG estradiol 0.001 MG/MG Topical Gel
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
Show the next 30 plans
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| FHCP Medicare Classic (HMO) | Florida Blue Medicare, Inc. | T2 | No | $0 | FL |
| CareOregon Advantage Plus (HMO D-SNP) | Health Plan OF Careoregon, Inc. | T2 | No | $0 | OR |
| PacificSource Medicare Essentials Rx 27 (HMO) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $19.00 | ID |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $29.10 | OR |
| FHCP Medicare Rx Plus (HMO-POS) | Florida Blue Medicare, Inc. | T2 | No | $49.00 | FL |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | Pacificsource Community Health Plans | T2 | No | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | Pacificsource Community Health Plans | T2 | No | $88.70 | OR |
| PacificSource Medicare Essentials Rx 6 (HMO) | Pacificsource Community Health Plans | T2 | No | $105.90 | OR |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T3 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T3 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T3 | No | $0 | NY |
| Network Health Select (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Go (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Anywhere (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Choice (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1250 MG estradiol 0.001 MG/MG Topical Gel covered by Medicare Part D?
Yes, 1250 MG estradiol 0.001 MG/MG Topical Gel is covered by 451 Medicare Part D plans (8.9% of all Part D formularies).
What tier is 1250 MG estradiol 0.001 MG/MG Topical Gel on Medicare Part D plans?
1250 MG estradiol 0.001 MG/MG Topical Gel averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does 1250 MG estradiol 0.001 MG/MG Topical Gel require prior authorization?
0% of Part D formularies require prior authorization for 1250 MG estradiol 0.001 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 2.6%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- {4 (ozanimod 0.23 MG Oral Capsule [Zeposia]) / 3 (ozanimod 0.46 MG Oral Capsule [Zeposia]) } Pack [Zeposia 7-Day Starter Pack] T3.6
- ozanimod 0.92 MG Oral Capsule [Zeposia] T3.6
- somatropin 6 MG Cartridge [Humatrope] T3.6
- {2 (1.17 ML romosozumab-aqqg 89.7 MG/ML Prefilled Syringe [Evenity]) } Pack [Evenity 210 MG Dose] T3.6
- lopinavir 80 MG/ML / ritonavir 20 MG/ML Oral Solution [Kaletra] T3.6
- nemolizumab-ilto 30 MG Auto-Injector [Nemluvio] T3.6