estradiol 0.1 MG/ML Vaginal Cream [Estrace]

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estradiol

RxCUI: 890918

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
2.3%
Plan Coverage
118
Plans Covering
T1.5
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for estradiol 0.1 MG/ML Vaginal Cream [Estrace]

Per the CMS 2026 Part D formulary file, estradiol 0.1 MG/ML Vaginal Cream [Estrace] (RxNorm concept RXCUI 890918, generic name estradiol) appears on 4 distinct formulary files spanning 118 Medicare Part D plan offerings - 2.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 2, with a cross-plan average of Tier 1.5.

Real-world access to estradiol 0.1 MG/ML Vaginal Cream [Estrace] 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 0.1 MG/ML Vaginal Cream [Estrace] 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 0.1 MG/ML Vaginal Cream [Estrace] today.

Coverage Details

Formularies covering
4
Plans covering
118
Coverage rate
2.3%
Tier range
Tier 1 – Tier 2
Average tier
Tier 2, Generic

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

3 plans
Tier 1, Preferred Generic
97 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering estradiol 0.1 MG/ML Vaginal Cream [Estrace]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic (HMO) KAISER FOUNDATION HP, INC. T2 No $0 HI
Kaiser Permanente Medicare Advantage Value 1 VA (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 VA
Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Complete Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Essential Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Medicare Advantage Standard DC (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 DC

Frequently Asked Questions

Is estradiol 0.1 MG/ML Vaginal Cream [Estrace] covered by Medicare Part D?

Yes, estradiol 0.1 MG/ML Vaginal Cream [Estrace] is covered by 118 Medicare Part D plans (2.3% of all Part D formularies).

What tier is estradiol 0.1 MG/ML Vaginal Cream [Estrace] on Medicare Part D plans?

estradiol 0.1 MG/ML Vaginal Cream [Estrace] averages Tier 1.5 across Part D plans, ranging from Tier 1 to Tier 2.

Does estradiol 0.1 MG/ML Vaginal Cream [Estrace] require prior authorization?

0% of Part D formularies require prior authorization for estradiol 0.1 MG/ML Vaginal Cream [Estrace]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on estradiol 0.1 MG/ML Vaginal Cream [Estrace]?

In 2023, total Medicare Part D spending on estradiol 0.1 MG/ML Vaginal Cream [Estrace] was $239,154,624, covering 1,289,816 beneficiaries. The average spend per beneficiary was $185.42.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial