FillMapPacificSource Medicare Essentials Rx 27 (HMO)

Does PacificSource Medicare Essentials Rx 27 (HMO) cover estradiol?

PacificSource Medicare Essentials Rx 27 (HMO)
H3864-027-0 · MA_LOCAL · Medicare Part D
estradiol
Do you get help with your Medicare drug costs?None of these

Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.

estradiolunder PacificSource Medicare Essentials Rx 27 (HMO)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$8per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Amount limit applies — this plan covers 18 tablets per 28 days. You can still fill it — more than that needs your plan's approval, which your doctor's office requests.
Tier
Tier 2
Approval first
Not needed
Try another first
No
Amount limit
18 tablets per 28 days
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.

Covered forms and strengths (40)

  • 1000 MG estradiol 0.001 MG/MG Topical GelTier 2
  • 1250 MG estradiol 0.001 MG/MG Topical GelTier 2
  • 168 HR estradiol 0.000583 MG/HR Transdermal System [Menostar]Tier 4
  • 168 HR estradiol 0.00104 MG/HR Transdermal SystemTier 2
  • 168 HR estradiol 0.00156 MG/HR Transdermal SystemTier 2
  • 168 HR estradiol 0.00208 MG/HR Transdermal SystemTier 2
  • 168 HR estradiol 0.0025 MG/HR Transdermal SystemTier 2
  • 168 HR estradiol 0.00312 MG/HR Transdermal SystemTier 2
  • 168 HR estradiol 0.00417 MG/HR Transdermal SystemTier 2
  • 250 MG estradiol 0.001 MG/MG Topical GelTier 2
  • 500 MG estradiol 0.001 MG/MG Topical GelTier 2
  • 750 MG estradiol 0.001 MG/MG Topical GelTier 2
  • 84 HR estradiol 0.00104 MG/HR Transdermal SystemTier 2
  • 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]Tier 2
  • 84 HR estradiol 0.00104 MG/HR Transdermal System [Lyllana]Tier 2
  • 84 HR estradiol 0.00156 MG/HR Transdermal SystemTier 2
  • 84 HR estradiol 0.00156 MG/HR Transdermal System [Dotti]Tier 2
  • 84 HR estradiol 0.00156 MG/HR Transdermal System [Lyllana]Tier 2
  • 84 HR estradiol 0.00208 MG/HR Transdermal SystemTier 2
  • 84 HR estradiol 0.00208 MG/HR Transdermal System [Dotti]Tier 2
  • 84 HR estradiol 0.00208 MG/HR Transdermal System [Lyllana]Tier 2
  • 84 HR estradiol 0.00313 MG/HR Transdermal SystemTier 2
  • 84 HR estradiol 0.00313 MG/HR Transdermal System [Dotti]Tier 2
  • 84 HR estradiol 0.00313 MG/HR Transdermal System [Lyllana]Tier 2
  • 84 HR estradiol 0.00417 MG/HR Transdermal SystemTier 2
  • 84 HR estradiol 0.00417 MG/HR Transdermal System [Dotti]Tier 2
  • 84 HR estradiol 0.00417 MG/HR Transdermal System [Lyllana]Tier 2
  • 90 DAY estradiol 0.000313 MG/HR Vaginal System [Estring]Tier 4
  • 90 DAY estradiol 0.00208 MG/HR Vaginal System [Femring]Tier 4
  • 90 DAY estradiol 0.00417 MG/HR Vaginal System [Femring]Tier 4
  • estradiol 0.01 MG Vaginal InsertTier 218 tablets per 28 days
  • estradiol 0.01 MG Vaginal Insert [Yuvafem]Tier 218 tablets per 28 days
  • estradiol 0.1 MG/ML Vaginal CreamTier 2
  • estradiol 0.5 MG Oral TabletTier 2
  • estradiol 1 MG Oral TabletTier 2
  • estradiol 2 MG Oral TabletTier 2
  • estradiol cypionate 5 MG/ML Injectable Solution [Depo-estradiol]Tier 4
  • estradiol valerate 10 MG/ML Injectable SolutionTier 2
  • estradiol valerate 20 MG/ML Injectable SolutionTier 2
  • estradiol valerate 40 MG/ML Injectable SolutionTier 2

← All coverage for estradiol