Medicare Part D coverage · {28 · RxCUI 1359129
{28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]
Per the CMS 2026 Part D formulary file, {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] is covered by 3,654 Medicare Part D plans (72.3% of enrollable products), averaging Tier 2.6, with prior authorization required on 12% of covering formularies.
- 72.3%
- Plan coverage
- 3,654
- Plans covering
- T2.6
- Avg tier
- 12%
- Prior auth required
What the CMS Formulary Data Shows for {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]
Per the CMS 2026 Part D formulary file, {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] (RxNorm concept RXCUI 1359129, generic name {28) appears on 283 distinct formulary files spanning 3,654 Medicare Part D plan offerings - 72.3% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.
Real-world access to {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] depends on utilization management as much as tier placement: 12% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,302 Part D beneficiaries filled {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] in 2023, with total plan-and-beneficiary spending of $502,035 and an average per-beneficiary annual cost of $385.59. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] today.
Coverage Details
- Formularies covering
- 283
- Plans covering
- 3,654
- Coverage rate
- 72.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 12% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,302
- Total spending
- $502,035
- Avg per beneficiary
- $385.59
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]
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 |
Show the next 30 plans
| 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 | Yes | $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 |
| 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 |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| 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 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] covered by Medicare Part D?
Yes, {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] is covered by 3,654 Medicare Part D plans (72.3% of all Part D formularies).
What tier is {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] on Medicare Part D plans?
{28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] require prior authorization?
12% of Part D formularies require prior authorization for {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]?
In 2023, total Medicare Part D spending on {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey] was $502,035, covering 1,302 beneficiaries. The average spend per beneficiary was $385.59.
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
- 0.65 ML medroxyprogesterone acetate 160 MG/ML Prefilled Syringe [depo-subQ provera] T2.6
- 100 ML ciprofloxacin 2 MG/ML Injection T2.6
- {42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) / 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit] T2.6
- clonazepam 2 MG Disintegrating Oral Tablet T2.6
- etonogestrel 68 MG Drug Implant [Nexplanon] T2.6
- haloperidol decanoate 100 MG/ML Injectable Solution T2.6
Similar prior-authorization rate
- {5 (milnacipran hydrochloride 12.5 MG Oral Tablet [Savella]) / 8 (milnacipran hydrochloride 25 MG Oral Tablet [Savella]) / 42 (milnacipran hydrochloride 50 MG Oral Tablet [Savella]) } Pack [Savella 4-Week Titration] 12% PA
- milnacipran hydrochloride 100 MG Oral Tablet [Savella] 12% PA
- 50 ML clindamycin 12 MG/ML Injection 12% PA
- tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] 12.3% PA
- 50 ML clindamycin 18 MG/ML Injection 11.7% PA
- ampicillin 2000 MG Injection 11.7% PA