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Premarin is a brand of estrogens, conjugated (USP). 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, 4,908 of 5,492 Medicare Part D and Medicare Advantage drug plans (89.4%) list Premarin on their formulary, across 226 of 286 formularies. The most common placement is tier 3 (3,782 plans, 77.1% of those covering it). 0 of the covering plans require prior authorization (0%), 12 step therapy and 12 a quantity limit.
438 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 78 of them $0; 4,470 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: 4,901 of 5,496 plans covered it (89.2%); 2027: 4,908 of 5,492 (89.4%).
Of 4,367 plans offered in both years, 19 added it to the formulary and 59 dropped it.
Among plans covering it both years, 75 moved it to a higher tier and 205 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 107 |
| Tier 2 | 242 |
| Tier 3 | 3,782 |
| Tier 4 | 777 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 229 of 323 | 70.9% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,858 of 3,200 | 89.3% | 0% |
| Special needs plans (SNP) | 1,821 of 1,969 | 92.5% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 611 of 631 | Tier 4 | 0 |
| Wellcare | 234 of 268 | Tier 2 | 0 |
| HealthSpring | 191 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 63 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 1 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 103 of 114 | 90.4% |
| Alaska | 6 of 9 | 66.7% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 140 of 147 | 95.2% |
| Arkansas | 78 of 85 | 91.8% |
| California | 337 of 397 | 84.9% |
| Colorado | 93 of 106 | 87.7% |
| Connecticut | 50 of 54 | 92.6% |
| Delaware | 40 of 43 | 93% |
| District of Columbia | 8 of 12 | 66.7% |
| Florida | 536 of 545 | 98.3% |
| Georgia | 138 of 149 | 92.6% |
| Guam | 1 of 1 | 100% |
| Hawaii | 36 of 50 | 72% |
| Idaho | 32 of 45 | 71.1% |
| Illinois | 121 of 132 | 91.7% |
| Indiana | 127 of 138 | 92% |
| Iowa | 56 of 64 | 87.5% |
| Kansas | 81 of 84 | 96.4% |
| Kentucky | 116 of 121 | 95.9% |
| Louisiana | 123 of 125 | 98.4% |
| Maine | 42 of 52 | 80.8% |
| Maryland | 19 of 49 | 38.8% |
| Massachusetts | 73 of 89 | 82% |
| Michigan | 71 of 182 | 39% |
| Minnesota | 42 of 63 | 66.7% |
| Mississippi | 95 of 104 | 91.3% |
| Missouri | 167 of 170 | 98.2% |
| Montana | 23 of 27 | 85.2% |
| Nebraska | 45 of 51 | 88.2% |
| Nevada | 94 of 100 | 94% |
| New Hampshire | 23 of 25 | 92% |
| New Jersey | 70 of 73 | 95.9% |
| New Mexico | 64 of 68 | 94.1% |
| New York | 185 of 215 | 86% |
| North Carolina | 173 of 176 | 98.3% |
| North Dakota | 18 of 26 | 69.2% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 134 of 171 | 78.4% |
| Oklahoma | 79 of 81 | 97.5% |
| Oregon | 82 of 92 | 89.1% |
| Pennsylvania | 291 of 323 | 90.1% |
| Puerto Rico | 63 of 64 | 98.4% |
| Rhode Island | 23 of 29 | 79.3% |
| South Carolina | 85 of 89 | 95.5% |
| South Dakota | 20 of 30 | 66.7% |
| Tennessee | 145 of 156 | 92.9% |
| Texas | 397 of 407 | 97.5% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 50 of 53 | 94.3% |
| Vermont | 10 of 14 | 71.4% |
| Virginia | 134 of 144 | 93.1% |
| Washington | 91 of 114 | 79.8% |
| West Virginia | 67 of 69 | 97.1% |
| Wisconsin | 84 of 96 | 87.5% |
| Wyoming | 9 of 13 | 69.2% |
Medicare Part D paid for 1,347,594 30-day fills of Premarin in 2024 for about 231,793 enrollees, at an average total cost of $187.67 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Premarin and the rest of a client's list on every plan in their county.
Estimate Premarin 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.