{14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day]
estrogens,
RxCUI: 1000487
What the CMS Formulary Data Shows for {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day]
Per the CMS 2026 Part D formulary file, {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] (RxNorm concept RXCUI 1000487, generic name estrogens,) appears on 197 distinct formulary files spanning 1,826 Medicare Part D plan offerings - 36% 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 2.7.
Real-world access to {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] depends on utilization management as much as tier placement: 17.3% of covering formularies require prior authorization. 0% require step therapy. 2.5% 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 {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] today.
Coverage Details
- Formularies covering
- 197
- Plans covering
- 1,826
- Coverage rate
- 36%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 17.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 2.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| 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 |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | 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 Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | No | $4.80 | FL |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | AMERICAN HEALTH PLAN OF FL, INC. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | SECUR INC | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | SECUR INC | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
Frequently Asked Questions
Is {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] covered by Medicare Part D?
Yes, {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] is covered by 1,826 Medicare Part D plans (36% of all Part D formularies).
What tier is {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] on Medicare Part D plans?
{14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day] require prior authorization?
17.3% of Part D formularies require prior authorization for {14 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) / 14 (estrogens, conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day]. Step therapy: 0%. Quantity limits: 2.5%.
Read our methodology - how this data is sourced, computed, and verified.