{28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day]
drospirenone
RxCUI: 1483551
What the CMS Formulary Data Shows for {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day]
Per the CMS 2026 Part D formulary file, {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] (RxNorm concept RXCUI 1483551, generic name drospirenone) appears on 5 distinct formulary files spanning 30 Medicare Part D plan offerings - 0.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.6.
Real-world access to {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] 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 {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] today.
Coverage Details
- Formularies covering
- 5
- Plans covering
- 30
- Coverage rate
- 0.6%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day]
30 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $21.10 | WI |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $38.60 | WI |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $86.40 | NY |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $92.80 | WI |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $135.00 | NY |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $146.00 | NY |
Frequently Asked Questions
Is {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] covered by Medicare Part D?
Yes, {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] is covered by 30 Medicare Part D plans (0.6% of all Part D formularies).
What tier is {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] on Medicare Part D plans?
{28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] averages Tier 3.6 across Part D plans, ranging from Tier 2 to Tier 4.
Does {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day] require prior authorization?
0% of Part D formularies require prior authorization for {28 (drospirenone 0.25 MG / estradiol 0.5 MG Oral Tablet) } Pack [Angeliq 0.25/0.5 28 Day]. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.