Medicare Part D coverage · progesterone · RxCUI 153580
progesterone 0.08 MG/MG Vaginal Gel [Crinone]
Per the CMS 2026 Part D formulary file, progesterone 0.08 MG/MG Vaginal Gel [Crinone] is covered by 824 Medicare Part D plans (16.3% of enrollable products), averaging Tier 3.3, with prior authorization required on 100% of covering formularies.
- 16.3%
- Plan coverage
- 824
- Plans covering
- T3.3
- Avg tier
- 100%
- Prior auth required
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.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T4 | Yes | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | Yes | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | Yes | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | Yes | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T4 | Yes | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T4 | Yes | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T4 | Yes | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T4 | Yes | $0 | AL |
Show the next 30 plans
Showing top 50 of 95 plans.
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.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- suzetrigine 50 MG Oral Tablet [Journavx] T3.3
- tretinoin 0.0004 MG/MG Topical Gel T3.3
- emtricitabine 10 MG/ML Oral Solution [Emtriva] T3.3
- 200 ACTUAT ipratropium bromide 0.017 MG/ACTUAT Metered Dose Inhaler [Atrovent] T3.3
- 24 HR donepezil hydrochloride 10 MG / memantine hydrochloride 14 MG Extended Release Oral Capsule [Namzaric] T3.3
- 24 HR donepezil hydrochloride 10 MG / memantine hydrochloride 7 MG Extended Release Oral Capsule [Namzaric] T3.3
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA