Medicare Part D coverage · estradiol · RxCUI 2108930
estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
Per the CMS 2026 Part D formulary file, estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] is covered by 264 Medicare Part D plans (5.2% of enrollable products), averaging Tier 3.2, with prior authorization required on 83.3% of covering formularies.
- 5.2%
- Plan coverage
- 264
- Plans covering
- T3.2
- Avg tier
- 83.3%
- Prior auth required
What the CMS Formulary Data Shows for estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
Per the CMS 2026 Part D formulary file, estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] (RxNorm concept RXCUI 2108930, generic name estradiol) appears on 6 distinct formulary files spanning 264 Medicare Part D plan offerings - 5.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] depends on utilization management as much as tier placement: 83.3% 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 1,289,816 Part D beneficiaries filled estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] in 2023, with total plan-and-beneficiary spending of $239,028,017 and an average per-beneficiary annual cost of $185.32. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 264
- Coverage rate
- 5.2%
- Tier range
- Tier 3 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 83.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,289,816
- Total spending
- $239,028,017
- Avg per beneficiary
- $185.32
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T3 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T3 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T3 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T3 | Yes | $0 | CA |
| Anthem Full Dual Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T3 | Yes | $0 | IN |
| Anthem I PathWays Dual Care Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T3 | Yes | $0 | IN |
| Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) | Anthem Insurance Companies, Inc. | T3 | Yes | $0 | IN |
| Wellpoint Full Dual Advantage (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T3 | Yes | $0 | IA |
| Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T3 | Yes | $0 | IA |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint West Virginia , Inc. | T3 | Yes | $0 | WV |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T3 | Yes | $0 | WA |
| Wellpoint Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T3 | Yes | $0 | WA |
| Healthy Blue Dual Advantage (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T3 | Yes | $0 | LA |
| Healthy Blue Dual Advantage 2 (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T3 | Yes | $0 | LA |
| Anthem Dual Advantage (PPO D-SNP) | Anthem Insurance Companies, Inc. | T3 | Yes | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Texas, Inc. | T3 | Yes | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | Wellpoint Texas, Inc. | T3 | Yes | $0 | TX |
| Wellpoint Dual Advantage 2 (HMO D-SNP) | Wellpoint Texas, Inc. | T3 | Yes | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | Wellpoint Texas, Inc. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | Wellpoint Texas, Inc. | T3 | Yes | $0 | TX |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] covered by Medicare Part D?
Yes, estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] is covered by 264 Medicare Part D plans (5.2% of all Part D formularies).
What tier is estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] on Medicare Part D plans?
estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] averages Tier 3.2 across Part D plans, ranging from Tier 3 to Tier 4.
Does estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] require prior authorization?
83.3% of Part D formularies require prior authorization for estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]?
In 2023, total Medicare Part D spending on estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] was $239,028,017, covering 1,289,816 beneficiaries. The average spend per beneficiary was $185.32.
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
- dexlansoprazole 30 MG Delayed Release Oral Capsule T3.2
- Sprinkle 24 HR topiramate 150 MG Extended Release Oral Capsule T3.2
- leuprolide acetate 5 MG/ML Injectable Solution T3.2
- prednisone 5 MG/ML Oral Solution T3.2
- tazarotene 0.001 MG/MG Topical Gel T3.2
- 1 ML hydromorphone hydrochloride 10 MG/ML Injection T3.2
Similar prior-authorization rate
- 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] 83.3% PA
- sofosbuvir 400 MG Oral Tablet [Sovaldi] 83.3% PA
- triheptanoin 1000 MG/ML Oral Solution [Dojolvi] 83.3% PA
- American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] 83.3% PA
- 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard] 83.2% PA
- methotrexate 2.5 MG/ML Oral Solution [Xatmep] 83.4% PA