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Estring is a brand of estradiol. 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, 2,360 of 5,492 Medicare Part D and Medicare Advantage drug plans (43%) list Estring on their formulary, across 79 of 286 formularies. The most common placement is tier 4 (2,191 plans, 92.8% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 1,004 a quantity limit. Generic estradiol is on 5,492 of 5,492 plans (100%).
194 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $48.50, 22 of them $0; 2,166 charge coinsurance instead — median 27% 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: 3,361 of 5,496 plans covered it (61.2%); 2027: 2,360 of 5,492 (43%).
Of 4,367 plans offered in both years, 34 added it to the formulary and 841 dropped it.
Among plans covering it both years, 12 moved it to a higher tier and 1 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 25 |
| Tier 2 | 1 |
| Tier 3 | 143 |
| Tier 4 | 2,191 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 79 of 323 | 24.5% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,425 of 3,200 | 44.5% | 0% |
| Special needs plans (SNP) | 856 of 1,969 | 43.5% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 4 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 611 of 631 | Tier 4 | 0 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 186 of 226 | Tier 4 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 4 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 12 of 80 | Tier 4 | 0 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 69 of 74 | Tier 4 | 0 |
| Wellpoint | 45 of 63 | Tier 4 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 8 of 35 | Tier 4 | 0 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 21 of 26 | Tier 4 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 45 of 114 | 39.5% |
| Alaska | 2 of 9 | 22.2% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 50 of 147 | 34% |
| Arkansas | 34 of 85 | 40% |
| California | 229 of 397 | 57.7% |
| Colorado | 53 of 106 | 50% |
| Connecticut | 26 of 54 | 48.1% |
| Delaware | 21 of 43 | 48.8% |
| District of Columbia | 10 of 12 | 83.3% |
| Florida | 174 of 545 | 31.9% |
| Georgia | 76 of 149 | 51% |
| Guam | 1 of 1 | 100% |
| Hawaii | 15 of 50 | 30% |
| Idaho | 16 of 45 | 35.6% |
| Illinois | 50 of 132 | 37.9% |
| Indiana | 63 of 138 | 45.7% |
| Iowa | 28 of 64 | 43.8% |
| Kansas | 43 of 84 | 51.2% |
| Kentucky | 51 of 121 | 42.1% |
| Louisiana | 38 of 125 | 30.4% |
| Maine | 22 of 52 | 42.3% |
| Maryland | 19 of 49 | 38.8% |
| Massachusetts | 65 of 89 | 73% |
| Michigan | 39 of 182 | 21.4% |
| Minnesota | 21 of 63 | 33.3% |
| Mississippi | 42 of 104 | 40.4% |
| Missouri | 81 of 170 | 47.6% |
| Montana | 4 of 27 | 14.8% |
| Nebraska | 20 of 51 | 39.2% |
| Nevada | 45 of 100 | 45% |
| New Hampshire | 7 of 25 | 28% |
| New Jersey | 40 of 73 | 54.8% |
| New Mexico | 37 of 68 | 54.4% |
| New York | 77 of 215 | 35.8% |
| North Carolina | 79 of 176 | 44.9% |
| North Dakota | 13 of 26 | 50% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 66 of 171 | 38.6% |
| Oklahoma | 30 of 81 | 37% |
| Oregon | 27 of 92 | 29.3% |
| Pennsylvania | 123 of 323 | 38.1% |
| Puerto Rico | 1 of 64 | 1.6% |
| Rhode Island | 14 of 29 | 48.3% |
| South Carolina | 44 of 89 | 49.4% |
| South Dakota | 15 of 30 | 50% |
| Tennessee | 74 of 156 | 47.4% |
| Texas | 198 of 407 | 48.6% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 23 of 53 | 43.4% |
| Vermont | 2 of 14 | 14.3% |
| Virginia | 70 of 144 | 48.6% |
| Washington | 57 of 114 | 50% |
| West Virginia | 30 of 69 | 43.5% |
| Wisconsin | 47 of 96 | 49% |
| Wyoming | 2 of 13 | 15.4% |
Medicare Part D paid for 267,401 30-day fills of Estring in 2024 for about 33,056 enrollees, at an average total cost of $183.69 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Estring and the rest of a client's list on every plan in their county.
Estimate Estring 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.