Drug Coverage Lookup

See how a prescription drug is placed across Medicare Part D plan formularies — tier, prior authorization, step therapy, and quantity limits, counted per unique plan.

Nextstellis (Drospirenone and Estetrol)

On Part D plan formularies

Found on the formularies of 2 of 5499 Medicare Part D plans in this dataset · Tier 2.

This is dataset-wide formulary placement (data current through 2026-08-31) — check your specific plan for its current coverage and restrictions.

Found on the formularies of 2 of 5499 Medicare Part D plans in this dataset (Tier 2). Check your specific plan for its tier and copay — a low tier does not always beat a discount card.
Compare cash & discount prices →
PlanTierPrior AuthStep TherapyQty Limit
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) Tier 2 No No None
CareAdvantage (HMO D-SNP) (H6019-001) (CA) Tier 2 No No None

One row per plan; a Yes means the flag applies to at least one form/strength on that plan.

Acquisition cost (NADAC): $7.66753/unit — price effective 06/01/2026

For benefits professionals
Plan sponsors and advisors: formulary-placement and utilization analysis across plans.
For benefits teams: plan formulary analysis →

Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · NADAC price effective 06/01/2026 (per-NDC last change, not a data-staleness date). Dataset-wide plan-year formulary placement, not a guarantee of your individual benefit — confirm with your plan or pharmacist.

Data: CMS Monthly Part D formulary files · FDA/RxNorm drug identity · CMS NADAC pricing — CMS Part D formulary data current through 2026-08-31 · source

Machine access — this tool is available as structured data for AI assistants and agents:
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=drospirenone-and-estetrol
InsureWith Assistant
Hi! I can help you understand drug coverage, formulary tiers, prior authorization, and more. What would you like to know?