{18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack]
estradiol
RxCUI: 2054318
What the CMS Formulary Data Shows for {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack]
Per the CMS 2026 Part D formulary file, {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] (RxNorm concept RXCUI 2054318, generic name estradiol) appears on 37 distinct formulary files spanning 457 Medicare Part D plan offerings - 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 2.5.
Real-world access to {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] depends on utilization management as much as tier placement: 10.8% of covering formularies require prior authorization. 5.4% require step therapy. 16.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,850 Part D beneficiaries filled {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] in 2023, with total plan-and-beneficiary spending of $13,091,359 and an average per-beneficiary annual cost of $1,479.25. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] today.
Coverage Details
- Formularies covering
- 37
- Plans covering
- 457
- Coverage rate
- 9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 10.8% of formularies
- Step therapy required
- 5.4% of formularies
- Quantity limits
- 16.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 8,850
- Total spending
- $13,091,359
- Avg per beneficiary
- $1,479.25
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack]
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 |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $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 |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | No | $8.80 | MI |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | No | $15.20 | IL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | No | $21.70 | NH |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | No | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | No | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | No | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T3 | No | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T3 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Complete Blue HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T3 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T3 | No | $0 | WV |
Frequently Asked Questions
Is {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] covered by Medicare Part D?
Yes, {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] is covered by 457 Medicare Part D plans (9% of all Part D formularies).
What tier is {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] on Medicare Part D plans?
{18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] require prior authorization?
10.8% of Part D formularies require prior authorization for {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack]. Step therapy: 5.4%. Quantity limits: 16.2%.
How much does Medicare spend on {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack]?
In 2023, total Medicare Part D spending on {18 (estradiol 0.01 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 10 MCG Starter Pack] was $13,091,359, covering 8,850 beneficiaries. The average spend per beneficiary was $1,479.25.
Read our methodology - how this data is sourced, computed, and verified.