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.
Bijuva (Estradiol and Progesterone)
Estrogen
Found on the formularies of 289 of 5499 Medicare Part D plans in this dataset · Tiers 3–4 · prior authorization on 269 plans (93%), counting a plan when at least one form/strength carries the flag.
This is dataset-wide formulary placement (data current through 2026-08-31) — check your specific plan for its current coverage and restrictions.
| Plan | Tier | Prior Auth | Step Therapy | Qty Limit |
|---|---|---|---|---|
| Anthem I CareMore Medicare Advantage 2 (HMO-POS) (H0544-002) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) (H0544-004) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Home Care (HMO I-SNP) (H0544-005) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) (H0544-010) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) (H0544-014) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) (H0544-015) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) (H0544-019) (CA) | Tier 3 | Yes | No | None |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) (H0544-020) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-056) (CA) | Tier 3 | Yes | No | None |
| Anthem Select (HMO-POS) (H0544-058) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-061) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-062) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-063) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-064) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-065) (CA) | Tier 3 | Yes | No | None |
| Anthem Select (HMO-POS) (H0544-066) (CA) | Tier 3 | Yes | No | None |
| Anthem Select (HMO-POS) (H0544-069) (CA) | Tier 3 | Yes | No | None |
| Anthem Select (HMO-POS) (H0544-091) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-095) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-096) (CA) | Tier 3 | Yes | No | None |
| Anthem Select (HMO-POS) (H0544-098) (CA) | Tier 3 | Yes | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-108) (CA) | Tier 3 | Yes | No | None |
| Anthem Full Dual Advantage (HMO D-SNP) (H0629-001) (IN) | Tier 3 | Yes | No | None |
| Anthem I PathWays Dual Care Advantage (HMO D-SNP) (H0629-003) (IN) | Tier 3 | Yes | No | None |
| Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) (H0629-004) (IN) | Tier 3 | Yes | No | None |
One row per plan — showing 25 of 289 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $8.84931/unit — price effective 06/01/2026
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
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=estradiol-and-progesterone