estradiol 0.0006 MG/MG Topical Gel [Elestrin]
estradiol
RxCUI: 706467
What the CMS Formulary Data Shows for estradiol 0.0006 MG/MG Topical Gel [Elestrin]
Per the CMS 2026 Part D formulary file, estradiol 0.0006 MG/MG Topical Gel [Elestrin] (RxNorm concept RXCUI 706467, generic name estradiol) appears on 2 distinct formulary files spanning 19 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to estradiol 0.0006 MG/MG Topical Gel [Elestrin] depends on utilization management as much as tier placement: 0% 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 0.0006 MG/MG Topical Gel [Elestrin] 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 0.0006 MG/MG Topical Gel [Elestrin] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 19
- Coverage rate
- 0.4%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% 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
Medicare Advantage Plans (MA-PD) Covering estradiol 0.0006 MG/MG Topical Gel [Elestrin]
19 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $86.40 | NY |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $135.00 | NY |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $146.00 | NY |
Frequently Asked Questions
Is estradiol 0.0006 MG/MG Topical Gel [Elestrin] covered by Medicare Part D?
Yes, estradiol 0.0006 MG/MG Topical Gel [Elestrin] is covered by 19 Medicare Part D plans (0.4% of all Part D formularies).
What tier is estradiol 0.0006 MG/MG Topical Gel [Elestrin] on Medicare Part D plans?
estradiol 0.0006 MG/MG Topical Gel [Elestrin] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does estradiol 0.0006 MG/MG Topical Gel [Elestrin] require prior authorization?
0% of Part D formularies require prior authorization for estradiol 0.0006 MG/MG Topical Gel [Elestrin]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on estradiol 0.0006 MG/MG Topical Gel [Elestrin]?
In 2023, total Medicare Part D spending on estradiol 0.0006 MG/MG Topical Gel [Elestrin] 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.