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Estradiol / Norethindrone is a generic drug. What agents check before quoting it: how many 2027 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2027, 4,192 of 5,492 Medicare Part D and Medicare Advantage drug plans (76.3%) list Estradiol / Norethindrone on their formulary, across 256 of 286 formularies. The most common placement is tier 3 (1,537 plans, 36.7% of those covering it). 21 of the covering plans require prior authorization (0.5%), 0 step therapy and 0 a quantity limit.
1,485 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 744 of them $0; 2,707 charge coinsurance instead — median 25% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,400 in 2027, covered drugs cost $0 for the rest of the year.
2026: 4,103 of 5,496 plans covered it (74.7%); 2027: 4,192 of 5,492 (76.3%).
Of 4,367 plans offered in both years, 2 added it to the formulary and 14 dropped it.
Among plans covering it both years, 865 moved it to a higher tier and 832 to a lower one; 4 added prior authorization and 163 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 234 |
| Tier 2 | 1,325 |
| Tier 3 | 1,537 |
| Tier 4 | 1,096 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 277 of 323 | 85.8% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,435 of 3,200 | 76.1% | 0.3% |
| Special needs plans (SNP) | 1,480 of 1,969 | 75.2% | 0.9% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 73 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 2 | 0 |
| Aetna Medicare | 631 of 631 | Tier 4 | 0 |
| Wellcare | 268 of 268 | Tier 3 | 0 |
| HealthSpring | 0 of 226 | No tier listed | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 2 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 2 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 4 | 0 |
| Wellpoint | 63 of 63 | Tier 4 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 36 of 36 | Tier 2 | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 2 | 0 |
| Medica | 27 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 4 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 82 of 114 | 71.9% |
| Alaska | 8 of 9 | 88.9% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 121 of 147 | 82.3% |
| Arkansas | 66 of 85 | 77.6% |
| California | 279 of 397 | 70.3% |
| Colorado | 67 of 106 | 63.2% |
| Connecticut | 46 of 54 | 85.2% |
| Delaware | 30 of 43 | 69.8% |
| District of Columbia | 4 of 12 | 33.3% |
| Florida | 430 of 545 | 78.9% |
| Georgia | 103 of 149 | 69.1% |
| Guam | 1 of 1 | 100% |
| Hawaii | 37 of 50 | 74% |
| Idaho | 22 of 45 | 48.9% |
| Illinois | 105 of 132 | 79.5% |
| Indiana | 116 of 138 | 84.1% |
| Iowa | 52 of 64 | 81.3% |
| Kansas | 70 of 84 | 83.3% |
| Kentucky | 98 of 121 | 81% |
| Louisiana | 103 of 125 | 82.4% |
| Maine | 41 of 52 | 78.8% |
| Maryland | 31 of 49 | 63.3% |
| Massachusetts | 79 of 89 | 88.8% |
| Michigan | 129 of 182 | 70.9% |
| Minnesota | 55 of 63 | 87.3% |
| Mississippi | 75 of 104 | 72.1% |
| Missouri | 137 of 170 | 80.6% |
| Montana | 22 of 27 | 81.5% |
| Nebraska | 43 of 51 | 84.3% |
| Nevada | 76 of 100 | 76% |
| New Hampshire | 19 of 25 | 76% |
| New Jersey | 56 of 73 | 76.7% |
| New Mexico | 37 of 68 | 54.4% |
| New York | 187 of 215 | 87% |
| North Carolina | 134 of 176 | 76.1% |
| North Dakota | 21 of 26 | 80.8% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 138 of 171 | 80.7% |
| Oklahoma | 58 of 81 | 71.6% |
| Oregon | 78 of 92 | 84.8% |
| Pennsylvania | 272 of 323 | 84.2% |
| Puerto Rico | 38 of 64 | 59.4% |
| Rhode Island | 19 of 29 | 65.5% |
| South Carolina | 69 of 89 | 77.5% |
| South Dakota | 27 of 30 | 90% |
| Tennessee | 119 of 156 | 76.3% |
| Texas | 305 of 407 | 74.9% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 39 of 53 | 73.6% |
| Vermont | 13 of 14 | 92.9% |
| Virginia | 99 of 144 | 68.8% |
| Washington | 73 of 114 | 64% |
| West Virginia | 58 of 69 | 84.1% |
| Wisconsin | 74 of 96 | 77.1% |
| Wyoming | 10 of 13 | 76.9% |
Medicare Part D paid for 114,825 30-day fills of Estradiol / Norethindrone in 2024 for about 14,500 enrollees, at an average total cost of $42.25 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Estradiol / Norethindrone and the rest of a client's list on every plan in their county.
Estimate Estradiol / Norethindrone costs by plan
Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 10/08/2026). CMS formulary data.