Medicare Part D coverage · 84 · RxCUI 2399892
84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]
Per the CMS 2026 Part D formulary file, 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] is covered by 3,237 Medicare Part D plans (64.1% of enrollable products), averaging Tier 2.9, with prior authorization required on 1.5% of covering formularies.
- 64.1%
- Plan coverage
- 3,237
- Plans covering
- T2.9
- Avg tier
- 1.5%
- Prior auth required
What the CMS Formulary Data Shows for 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]
Per the CMS 2026 Part D formulary file, 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] (RxNorm concept RXCUI 2399892, generic name 84) appears on 200 distinct formulary files spanning 3,237 Medicare Part D plan offerings - 64.1% 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 2.9.
Real-world access to 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] depends on utilization management as much as tier placement: 1.5% of covering formularies require prior authorization. 0% require step therapy. 36% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 5,567 Part D beneficiaries filled 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] in 2023, with total plan-and-beneficiary spending of $1,998,050 and an average per-beneficiary annual cost of $358.91. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] today.
Coverage Details
- Formularies covering
- 200
- Plans covering
- 3,237
- Coverage rate
- 64.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 1.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 36% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,567
- Total spending
- $1,998,050
- Avg per beneficiary
- $358.91
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]
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 |
| 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 |
| 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 |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] covered by Medicare Part D?
Yes, 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] is covered by 3,237 Medicare Part D plans (64.1% of all Part D formularies).
What tier is 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] on Medicare Part D plans?
84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] require prior authorization?
1.5% of Part D formularies require prior authorization for 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]. Step therapy: 0%. Quantity limits: 36%.
How much does Medicare spend on 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]?
In 2023, total Medicare Part D spending on 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana] was $1,998,050, covering 5,567 beneficiaries. The average spend per beneficiary was $358.91.
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
Similar prior-authorization rate
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