medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera]

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medroxyprogesterone acetate

RxCUI: 1000139

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.
0%
Plan Coverage
2
Plans Covering
T1
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera]

Per the CMS 2026 Part D formulary file, medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] (RxNorm concept RXCUI 1000139, generic name medroxyprogesterone acetate) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] 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 108,623 Part D beneficiaries filled medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] in 2023, with total plan-and-beneficiary spending of $9,563,405 and an average per-beneficiary annual cost of $88.04. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
108,623
Total spending
$9,563,405
Avg per beneficiary
$88.04

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera]

2 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
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY

Frequently Asked Questions

Is medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] covered by Medicare Part D?

Yes, medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] on Medicare Part D plans?

medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] require prior authorization?

0% of Part D formularies require prior authorization for medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera]?

In 2023, total Medicare Part D spending on medroxyprogesterone acetate 2.5 MG Oral Tablet [Provera] was $9,563,405, covering 108,623 beneficiaries. The average spend per beneficiary was $88.04.

Read our methodology - how this data is sourced, computed, and verified.

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