progesterone 0.08 MG/MG Vaginal Gel [Crinone]
progesterone
RxCUI: 153580
What the CMS Formulary Data Shows for progesterone 0.08 MG/MG Vaginal Gel [Crinone]
Per the CMS 2026 Part D formulary file, progesterone 0.08 MG/MG Vaginal Gel [Crinone] (RxNorm concept RXCUI 153580, generic name progesterone) appears on 11 distinct formulary files spanning 824 Medicare Part D plan offerings - 16.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.3.
Real-world access to progesterone 0.08 MG/MG Vaginal Gel [Crinone] depends on utilization management as much as tier placement: 100% 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 109 Part D beneficiaries filled progesterone 0.08 MG/MG Vaginal Gel [Crinone] in 2023, with total plan-and-beneficiary spending of $13,830 and an average per-beneficiary annual cost of $126.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry progesterone 0.08 MG/MG Vaginal Gel [Crinone] today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 824
- Coverage rate
- 16.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 109
- Total spending
- $13,830
- Avg per beneficiary
- $126.88
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering progesterone 0.08 MG/MG Vaginal Gel [Crinone]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering progesterone 0.08 MG/MG Vaginal Gel [Crinone]
95 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is progesterone 0.08 MG/MG Vaginal Gel [Crinone] covered by Medicare Part D?
Yes, progesterone 0.08 MG/MG Vaginal Gel [Crinone] is covered by 824 Medicare Part D plans (16.3% of all Part D formularies).
What tier is progesterone 0.08 MG/MG Vaginal Gel [Crinone] on Medicare Part D plans?
progesterone 0.08 MG/MG Vaginal Gel [Crinone] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does progesterone 0.08 MG/MG Vaginal Gel [Crinone] require prior authorization?
100% of Part D formularies require prior authorization for progesterone 0.08 MG/MG Vaginal Gel [Crinone]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on progesterone 0.08 MG/MG Vaginal Gel [Crinone]?
In 2023, total Medicare Part D spending on progesterone 0.08 MG/MG Vaginal Gel [Crinone] was $13,830, covering 109 beneficiaries. The average spend per beneficiary was $126.88.
Read our methodology - how this data is sourced, computed, and verified.