DOTTI .1 mg/d Patch, Extended Release
Also known as Estradiol. Coverage in Kansas (CMS PDP Region 24).
10 of 12 stand-alone Part D plans in Kansas cover this drug on tier 3–4.
7 of 10 plans apply a prior authorization, step therapy or quantity limit.
59 Medicare Advantage plans in KS do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. KS: 59 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 3Preferred Brand | 20% | 20% | $9.4353 | — | None |
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $9.9784 | — | None |
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $9.4353 | — | None |
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $8.4811 | $76.339 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $8.0972 | $72.879 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $8.0972 | $72.879 units |
|
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $8.9385 | $80.459 units |
|
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $9.3634 | $84.279 units |
|
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $5.8062 | $52.269 units |
|
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $8.6995 | $78.309 units |
|
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.