Key takeaways:
Premarin (conjugated estrogens) is an estrogen medication that can treat many symptoms of menopause, including hot flashes, night sweats, and vaginal dryness.
Premarin is available as an oral tablet and a vaginal cream. The form you use depends on the symptoms you’re experiencing.
Without insurance, 30 tablets of 0.3 mg Premarin tablets can cost an average of $274.13. GoodRx can help you access Premarin tablets at an exclusive cash price of $99 per month. Manufacturer savings cards and patient assistance programs are also available.
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Menopause is the time when your ovaries stop releasing eggs and your menstrual cycle stops. This transition typically begins between ages 45 and 55 and lasts several years. Many people experiencing menopause have symptoms such as hot flashes and vaginal dryness.
Premarin (conjugated estrogens) is a medication that can provide relief if you’re experiencing menopause symptoms. And Premarin Vaginal Cream specifically treats vaginal symptoms.
Menopause starts when your ovaries stop releasing eggs. This change causes your ovaries to produce less estrogen, which can lead to symptoms such as hot flashes and vaginal dryness. Premarin, which comes as a tablet and a vaginal cream, works by raising estrogen levels in the body.
The cost of Premarin depends on several factors, including your dose, your dosage form, and the pharmacy where you fill your prescription. If your health insurance doesn’t cover Premarin, a GoodRx coupon could lower your cost at certain pharmacies.
Premarin basics
Premarin is an estrogen medication. The oral tablets can help manage full-body menopause symptoms, including hot flashes and vaginal dryness. Premarin Vaginal Cream targets only vaginal symptoms. Your healthcare team can help you pick the best dosage form for you. But if you’re experiencing only vaginal symptoms, it’s recommended to try a vaginal estrogen first.
It’s important to note that if you have a uterus, you’ll likely also take a progestin — such as medroxyprogesterone (Provera) — with Premarin tablets. This helps protect the uterus from damage that can be caused by taking oral estrogen alone.
The chart below provides a summary of basic information about Premarin.
Premarin basics
| Brand names | Premarin, Premarin Vaginal Cream |
| Forms |
|
| FDA-approved uses |
|
| Benefits |
|
| Possible side effects | Possible side effects of Premarin tablets:
Possible side effects of Premarin Vaginal Cream:
Both forms of Premarin also come with several boxed warnings (the FDA’s most serious warning for medications). Taking estrogen can increase your risk of:
Keep in mind that Premarin Vaginal Cream has a much lower risk of these complications than Premarin tablets. And taking the lowest Premarin dose needed for the shortest time possible helps lower your risk of these rare but serious side effects. |
Good to know: Premarin is made from the urine of pregnant mares. This process provides a blend of estrogens that’s difficult to duplicate in a laboratory. Because of this, there’s no generic version of Premarin.
Is Premarin covered by insurance?
Many health insurance plans cover brand-name Premarin. Nearly all Medicaid and commercial plans purchased through an Affordable Care Act (ACA) marketplace cover this estrogen medication as a tablet and as cream.
If you have insurance, review your plan’s summary of benefits and coverage and formulary (list of covered medications) to determine whether Premarin is covered. If not, contact your prescription plan and ask about your coverage options. You also can discuss alternatives with your prescriber.
How insurance covers Premarin
The following charts show the likelihood of coverage for Premarin 0.3 mg tablets, 0.625 mg tablets, and the vaginal cream based on the type of insurance plan.
Most health insurance plans don’t require enrollees to get prior authorization or do step therapy, but some do. Prior authorization for Premarin tablets and vaginal cream is required for about 1 in 5 people covered by Medicaid.
Insurance coverage for Premarin (0.3 mg tablet)
Insurance type | Enrollees covered for Premarin, 0.3 mg tablet | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial plans (not including plans purchased through an ACA marketplace) | 69.8% | 6.3% | 0.1% |
90.9% | 14.3% | 0.5% | |
Medicare, including original Medicare and Medicare Advantage plans | 73.2% | 4.8% | 0.4% |
Medicaid, including state-run and managed care plans | 99.8% | 18.4% | 2.6% |
Insurance coverage for Premarin (0.625 mg tablet)
Insurance type | Enrollees covered for Premarin, 0.625 mg tablet | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial plans (not including plans purchased through an ACA marketplace) | 69.8% | 6.3% | 0.1% |
ACA plans | 90.9% | 14.3% | 0.5% |
Medicare, including original Medicare and Medicare Advantage plans | 73.2% | 4.8% | 0.4% |
Medicaid, including state-run and managed care plans | 99.8% | 18.1% | 2.6% |
Insurance coverage for Premarin Vaginal Cream (1 tube)
Insurance type | Enrollees covered for Premarin Vaginal Cream, 1 tube | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial plans (not including plans purchased through an ACA marketplace) | 80% | 4.5% | 0.1% |
ACA plans | 94% | 2.8% | 2.3% |
Medicare, including original Medicare and Medicare Advantage plans | 78.1% | 0% | 0.1% |
Medicaid, including state-run and managed care plans | 98.2% | 22.4% | 1.3% |
Source: Managed Markets Insight & Technology, LLC™, as of April 14, 2025. (See methodology below.)
Tips if your medication isn’t covered by insurance
If your insurance doesn’t cover Premarin, you still have options:
Use a GoodRx coupon to save on your prescription.
Ask your prescriber about less costly menopause treatments that meet your needs, including lower-cost generic medications.
Request a formulary exception from your insurance company to have your plan cover Premarin. If your request is denied, you have the right to file an appeal.
When it’s time for open enrollment, compare different health insurance plans to find one that provides the coverage you need.
Potential Premarin interactions: Grapefruit juice, certain antibiotics, and oral antifungals interact with Premarin and increase the chance of side effects from the estrogen medication.
You could experience side effects. Common Premarin side effects include headaches, nausea, and sore breasts. Less often, people also report trouble sleeping, depression, and pain.
Saving on Premarin: You can pay less for Premarin tablets and cream with these savings tips.
How much does Premarin cost without insurance?
If you don’t have insurance, the cost of Premarin may be challenging for your budget. What you are charged for Premarin depends on several factors, including your:
Pharmacy
Geographic location
Fill quantity
Medication dose
Dosage form
The following table shows what you might pay for different doses and forms of Premarin.
Premarin costs
Premarin form and doses | Average cash price |
|---|---|
30 tablets (0.3 mg) | |
30 tablets (0.45 mg) | |
30 tablets (0.625 mg) | |
30 tablets (0.9 mg) | |
30 tablets (1.25 mg) | |
1 tube of vaginal cream (30 g of 0.625 mg/g) |
Ways to save on Premarin without insurance
Premarin may be a stretch for your budget. Whether or not you have insurance, here are six ways to potentially reduce your cost:
1. Use a GoodRx coupon for exclusive discounts
You can use a free GoodRx coupon to lower the price of Premarin at your pharmacy. Visit www.goodrx.com, or download the GoodRx app on your mobile device to get a coupon. Here’s how:
On the app or website, type “Premarin” or “Premarin Vaginal Cream” in the search field.
Choose the dose and desired quantity. Input your ZIP code or address, or select “Use my current location,” so the results show pharmacies near you.
Choose how to receive your coupon (printed, emailed, or texted).
GoodRx has partnered with the manufacturer to offer exclusive discounts for cash-paying consumers:
A 30-day supply of Premarin tablets for $99 at participating pharmacies.
One tube of Premarin cream for $249 at participating pharmacies.
You will need to text, print, or email the GoodRx coupon that matches your prescription.
2. Manufacturer savings card
If you have commercial insurance and are ages 18 to 64, you may be eligible for the Pfizer savings card from the manufacturer. This can help you pay as little as $25 for a 30-supply of Premarin tablets or as low as $25 for one tube of Premarin cream. This copay card could save you up to $1,440 each calendar year.
3. Compare prices at various pharmacies
GoodRx lets you easily compare Premarin costs at different pharmacies in your area. You might find it’s worth traveling a bit to get a discounted price.
4. Manufacturer patient assistance program
Pfizer RxPathways can help eligible people access programs that provide Premarin for free. The associated patient assistance program (PAP) is available via an online platform called Pfizer PAP Connect. You may qualify as an uninsured person with a low income or if you’re covered by certain government insurance plans.
5. Ask your prescriber about alternatives
Premarin isn’t the only menopause relief medication out there. Ask your prescriber about lower-cost options that adequately treat your condition.
6. Use tax-advantaged healthcare funds
Consider using a flexible spending account, a health savings account, or a health reimbursement arrangement to cover your medication. These types of accounts have multiple tax benefits when used to cover healthcare costs. Using one of them can reduce your out-of-pocket costs through tax savings. Review your account’s contribution limits, rollover limits, and eligible expenses.
The bottom line
Premarin (conjugated estrogens) is a prescription medication available as an oral tablet or a vaginal cream that helps relieve menopause symptoms, including hot flashes and vaginal dryness.
The cost of Premarin depends on factors like your medication dosage form, pharmacy, and insurance coverage. If you don’t have insurance, the average price of 30 tablets of 0.3 mg Premarin is $274.13, and you could pay as little as $213.30 with a GoodRx coupon at select pharmacies.
People with commercial insurance may be eligible for the Pfizer savings card. This could lower your copay to as little as $25 for a 30-day supply of Premarin tablets or $25 for one tube of Premarin Vaginal Cream. GoodRx offers exclusive discounts for cash-paying consumers at participating pharmacies: $99 for a 30-day supply of Premarin tablets and $249 for one tube of Premarin Vaginal Cream. If you are uninsured or have certain kinds of government insurance, you may qualify for free Premarin through the manufacturer’s patient assistance program, which can be accessed at Pfizer PAP Connect.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of April 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including the ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
MedlinePlus. (2023). Menopause.
National Institute on Aging. (2024). What is menopause? National Institutes of Health.
Office on Women’s Health. (2025). Menopause symptoms and relief. U.S. Department of Health and Human Services.
Pfizer. (2024). Menopause Hormone Therapies (MHT) by Pfizer Savings Card.
Wyeth Pharmaceuticals. (2025). Premarin- estrogens, conjugated tablet, film coated [package insert]. DailyMed.
Wyeth Pharmaceuticals. (2025). Premarin vaginal- conjugated estrogens cream [package insert]. DailyMed.
