{21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack

Verify with CMS →

drospirenone

RxCUI: 748800

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
91.1%
Plan Coverage
4,615
Plans Covering
T2.2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack

Per the CMS 2026 Part D formulary file, {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack (RxNorm concept RXCUI 748800, generic name drospirenone) appears on 255 distinct formulary files spanning 4,615 Medicare Part D plan offerings - 91.1% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.2.

Real-world access to {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% 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 {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack today.

Coverage Details

Formularies covering
255
Plans covering
4,615
Coverage rate
91.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
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
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
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
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
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
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
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
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
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
MMM Supremo (HMO C-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Unico (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Elite (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Deluxe (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
PMC Max (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Plenitud (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Valioso (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR

Frequently Asked Questions

Is {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack covered by Medicare Part D?

Yes, {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack is covered by 4,615 Medicare Part D plans (91.1% of all Part D formularies).

What tier is {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack on Medicare Part D plans?

{21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack require prior authorization?

0% of Part D formularies require prior authorization for {21 (drospirenone 3 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack. Step therapy: 0%. Quantity limits: 0%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial