estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
estradiol
RxCUI: 2108930
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 $239,154,624 and an average per-beneficiary annual cost of $185.42. 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
- $239,154,624
- Avg per beneficiary
- $185.42
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Anthem Full Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T3 | Yes | No | $0 | CT |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T3 | Yes | No | $0 | CT |
| Anthem Kidney Care (HMO-POS C-SNP) | ANTHEM HEALTH PLANS, INC. | T3 | Yes | No | $0 | CT |
| Anthem Full Dual Advantage Select (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T3 | Yes | No | $0 | CT |
| Anthem Dual Advantage (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T3 | Yes | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva]
95 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 |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellpoint Full Dual Advantage (HMO D-SNP) | WELLPOINT TEXAS, INC. | T3 | Yes | $0 | TX |
| Anthem I MyCare Ohio Full Dual Advantage (HMO D-SNP) | COMMUNITY INSURANCE COMPANY | T3 | Yes | $0 | OH |
| Anthem Full Dual Advantage (HMO D-SNP) | COMMUNITY INSURANCE COMPANY | T3 | Yes | $0 | OH |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | COMMUNITY INSURANCE COMPANY | T3 | Yes | $0 | OH |
| Wellpoint Full Dual Advantage (HMO D-SNP) | WELLPOINT NEW JERSEY, INC. | T3 | Yes | $0 | NJ |
| Wellpoint Kidney Care (HMO-POS C-SNP) | WELLPOINT NEW JERSEY, INC. | T3 | Yes | $0 | NJ |
| Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) | WELLPOINT NEW JERSEY, INC. | T3 | Yes | $0 | NJ |
| Anthem Medicare Advantage (HMO-POS) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Full Dual Advantage (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | MO |
| Anthem Medicare Advantage 2 (HMO-POS) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Kidney Care (HMO-POS C-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Medicare Advantage (HMO-POS) | HealthKeepers, Inc. | T3 | Yes | $0 | MO |
| Anthem Medicare Advantage 4 (HMO-POS) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Medicare Advantage (HMO-POS) | HealthKeepers, Inc. | T3 | Yes | $0 | IN |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | MO |
| Anthem Chronic Care (HMO-POS C-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | MO |
| Anthem Medicare Advantage (HMO-POS) | COMMUNITY INSURANCE COMPANY | T3 | Yes | $0 | OH |
| Anthem Medicare Advantage (HMO) | HMO COLORADO, INC. | T3 | Yes | $0 | CO |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T3 | Yes | $0 | CA |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Dual Advantage (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Full Dual Advantage Support (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Full Dual Advantage (HMO D-SNP) | HealthKeepers, Inc. | T3 | Yes | $0 | VA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | T3 | Yes | $0 | GA |
| Anthem Kidney Care (HMO-POS C-SNP) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | T3 | Yes | $0 | GA |
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 $239,154,624, covering 1,289,816 beneficiaries. The average spend per beneficiary was $185.42.
Read our methodology - how this data is sourced, computed, and verified.