84 HR estradiol 0.00208 MG/HR / norethindrone acetate 0.00583 MG/HR Transdermal System [Combipatch]
estradiol
RxCUI: 1251495
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
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.
Read our methodology - how this data is sourced, computed, and verified.