84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]

Verify with CMS →

estradiol

RxCUI: 1251495

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.
22.1%
Plan Coverage
1,122
Plans Covering
T3.6
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]

Per the CMS 2026 Part D formulary file, 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] (RxNorm concept RXCUI 1251495, generic name estradiol) appears on 75 distinct formulary files spanning 1,122 Medicare Part D plan offerings - 22.1% 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 3.6.

Real-world access to 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 26.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,033 Part D beneficiaries filled 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] in 2023, with total plan-and-beneficiary spending of $4,681,878 and an average per-beneficiary annual cost of $1,543.65. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] today.

Coverage Details

Formularies covering
75
Plans covering
1,122
Coverage rate
22.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
26.7% of formularies

2023 Medicare Spending

Beneficiaries
3,033
Total spending
$4,681,878
Avg per beneficiary
$1,543.65

Tier Distribution Across Plans

13 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
85 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]

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

Plan Insurer Tier PA Premium States
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
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T2 No $0 CA
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
Providence Medicare Extra Part B Only + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 OR
Providence Medicare Prime + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 OR
Providence Medicare Dual Plus (HMO D-SNP) PROVIDENCE HEALTH ASSURANCE T4 No $0 OR
Providence Medicare Timber + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 OR, WA
Providence Medicare Pine + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 WA
Providence Medicare Extra + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 OR, WA
Providence Medicare Sycamore + Rx (HMO) PROVIDENCE HEALTH ASSURANCE T4 No $0 CA
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
Blue Medicare Essential Plus (HMO-POS) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T4 No $0 NC
Blue Medicare Choice (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T4 No $0 NC
Blue Medicare Essential (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T4 No $0 NC
Experience Health Medicare Advantage (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T4 No $0 NC
Healthy Blue + Medicare (HMO-POS D-SNP) BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH T4 No $0 NC
Blue Advantage Choice (PPO) BLUE CROSS AND BLUE SHIELD OF ALABAMA T4 No $0 AL
Blue Advantage Plus (PPO) PATRIUS HEALTH, INC. T4 No $0 MS
Blue Advantage Capital (PPO) PATRIUS HEALTH, INC. T4 No $0 MS
Blue Advantage Magnolia (PPO) PATRIUS HEALTH, INC. T4 No $0 MS
Blue Advantage Complete (PPO) BLUE CROSS AND BLUE SHIELD OF ALABAMA T4 No $0 AL
EmblemHealth VIP Value (HMO-POS) HEALTH INSURANCE PLAN OF GREATER NEW YORK T4 No $0 NY
EmblemHealth VIP Dual Reserve (HMO D-SNP) HEALTH INSURANCE PLAN OF GREATER NEW YORK T4 No $0 NY
EmblemHealth VIP Dual (HMO D-SNP) HEALTH INSURANCE PLAN OF GREATER NEW YORK T4 No $0 NY
EmblemHealth VIP Dual Enhanced (HMO D-SNP) HEALTH INSURANCE PLAN OF GREATER NEW YORK T4 No $0 NY
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T4 No $0 AZ

Frequently Asked Questions

Is 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] covered by Medicare Part D?

Yes, 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] is covered by 1,122 Medicare Part D plans (22.1% of all Part D formularies).

What tier is 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] on Medicare Part D plans?

84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] require prior authorization?

0% of Part D formularies require prior authorization for 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]. Step therapy: 0%. Quantity limits: 26.7%.

How much does Medicare spend on 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]?

In 2023, total Medicare Part D spending on 84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch] was $4,681,878, covering 3,033 beneficiaries. The average spend per beneficiary was $1,543.65.

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