Benefily
No prior authorization

Does Cigna require prior authorization for Dotti?

Cigna does not require prior authorization for Dotti on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]2110774171 / 17100171No prior authorization
84 HR estradiol 0.00156 MG/HR Transdermal System [Dotti]2110777171 / 17100171No prior authorization
84 HR estradiol 0.00208 MG/HR Transdermal System [Dotti]2110780171 / 17100171No prior authorization
84 HR estradiol 0.00313 MG/HR Transdermal System [Dotti]2110783171 / 17100171No prior authorization
84 HR estradiol 0.00417 MG/HR Transdermal System [Dotti]21107860 / 171000Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]

Dotti has 5 products in the corpus; this table is for 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSpring Achieve (HMO C-SNP)H4407-0342NoNoYes
HealthSpring Achieve (HMO C-SNP)H4513-0942NoNoYes
HealthSpring Achieve (HMO C-SNP)H4513-0972NoNoYes
HealthSpring Achieve (HMO C-SNP)H4513-0982NoNoYes
HealthSpring Alliance (HMO)H4513-0642NoNoYes
HealthSpring Preferred (HMO)H0439-0082NoNoYes
HealthSpring Preferred (HMO)H0439-0092NoNoYes
HealthSpring Preferred (HMO)H0439-0102NoNoYes
HealthSpring Preferred (HMO)H0439-0112NoNoYes
HealthSpring Preferred (HMO)H0439-0132NoNoYes
HealthSpring Preferred (HMO)H0439-0152NoNoYes
HealthSpring Preferred (HMO)H0439-0152NoNoYes
HealthSpring Preferred (HMO)H0439-0202NoNoYes
HealthSpring Preferred (HMO)H0672-0052NoNoYes
HealthSpring Preferred (HMO)H0672-0062NoNoYes
HealthSpring Preferred (HMO)H0672-0132NoNoYes
HealthSpring Preferred (HMO)H0672-0242NoNoYes
HealthSpring Preferred (HMO)H4407-0302NoNoYes
HealthSpring Preferred (HMO)H4407-0302NoNoYes
HealthSpring Preferred (HMO)H4407-0302NoNoYes
HealthSpring Preferred (HMO)H4407-0332NoNoYes
HealthSpring Preferred (HMO)H4407-0352NoNoYes
HealthSpring Preferred (HMO)H4513-0262NoNoYes
HealthSpring Preferred (HMO)H4513-0302NoNoYes
HealthSpring Preferred (HMO)H4513-0372NoNoYes
HealthSpring Preferred (HMO)H4513-0382NoNoYes
HealthSpring Preferred (HMO)H4513-0492NoNoYes
HealthSpring Preferred (HMO)H4513-0492NoNoYes
HealthSpring Preferred (HMO)H4513-0492NoNoYes
HealthSpring Preferred (HMO)H4513-0492NoNoYes
HealthSpring Preferred (HMO)H4513-0492NoNoYes
HealthSpring Preferred (HMO)H4513-0502NoNoYes
HealthSpring Preferred (HMO)H4513-0522NoNoYes
HealthSpring Preferred (HMO)H4513-0612NoNoYes
HealthSpring Preferred (HMO)H4513-0612NoNoYes
HealthSpring Preferred (HMO)H4513-0612NoNoYes
HealthSpring Preferred (HMO)H4513-0612NoNoYes
HealthSpring Preferred (HMO)H4513-0612NoNoYes
HealthSpring Preferred (HMO)H4513-0742NoNoYes
HealthSpring Preferred (HMO)H4513-0772NoNoYes
HealthSpring Preferred (HMO)H4513-0772NoNoYes
HealthSpring Preferred (HMO)H4513-0772NoNoYes
HealthSpring Preferred (HMO)H4513-0772NoNoYes
HealthSpring Preferred (HMO)H4513-0852NoNoYes
HealthSpring Preferred (HMO)H5410-0182NoNoYes
HealthSpring Preferred (HMO)H5410-0242NoNoYes
HealthSpring Preferred (HMO)H5410-0592NoNoYes
HealthSpring Preferred (HMO)H5410-0602NoNoYes
HealthSpring Preferred (HMO)H7020-0112NoNoYes
HealthSpring Preferred (HMO)H7020-0112NoNoYes
HealthSpring Preferred (HMO)H7020-0112NoNoYes
HealthSpring Preferred (HMO)H9460-0012NoNoYes
HealthSpring Preferred AL (HMO)H4513-0462NoNoYes
HealthSpring Preferred AL (HMO)H4513-0462NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0882NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0892NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0902NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0912NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0922NoNoYes
HealthSpring Preferred Full Savings (HMO)H4513-0932NoNoYes
HealthSpring Preferred GA (HMO)H0439-0032NoNoYes
HealthSpring Preferred GA (HMO)H0439-0032NoNoYes
HealthSpring Preferred Plus (HMO)H0439-0062NoNoYes
HealthSpring Preferred Plus (HMO)H4407-0272NoNoYes
HealthSpring Preferred Plus (HMO)H4513-0872NoNoYes
HealthSpring Preferred Plus (HMO)H4513-0872NoNoYes
HealthSpring Preferred Plus (HMO)H4513-0872NoNoYes
HealthSpring Preferred Plus (HMO)H4513-0872NoNoYes
HealthSpring Preferred Savings (HMO)H0439-0162NoNoYes
HealthSpring Preferred Savings (HMO)H0439-0172NoNoYes
HealthSpring Preferred Savings (HMO)H0439-0182NoNoYes
HealthSpring Preferred Savings (HMO)H0439-0192NoNoYes
HealthSpring Preferred Savings (HMO)H0439-0212NoNoYes
HealthSpring Preferred Savings (HMO)H0672-0162NoNoYes
HealthSpring Preferred Savings (HMO)H0672-0172NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0682NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0682NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0682NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0732NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0832NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0862NoNoYes
HealthSpring Preferred Savings (HMO)H4513-0952NoNoYes
HealthSpring Preferred Savings (HMO)H5410-0262NoNoYes
HealthSpring Preferred Savings (HMO)H7020-0102NoNoYes
HealthSpring Preferred Savings (HMO)H7020-0102NoNoYes
HealthSpring Preferred Savings (HMO)H7020-0102NoNoYes
HealthSpring Preferred Savings (HMO)H9460-0032NoNoYes
HealthSpring Premier (HMO-POS)H0439-0242NoNoYes
HealthSpring Premier (HMO-POS)H4513-0362NoNoYes
HealthSpring Premier (HMO-POS)H4513-0842NoNoYes
HealthSpring Premier (HMO-POS)H4513-0962NoNoYes
HealthSpring Primary (HMO)H4513-0353NoNoYes
HealthSpring Primary (HMO)H4513-0533NoNoYes
HealthSpring TotalCare (HMO D-SNP)H0439-0023NoNoYes
Showing 100 of 171 covering plans.
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Dotti at other payers

Or see Dotti across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.