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Medications
Bimatoprost (Lumigan, Durysta, and others) — plans on this site that list it on Tier 4
64 plans published on this site list this drug on Tier 4, grouped by company. Plans are sold by county — the service area under each plan shows where it is offered.
Aspire Health
4 plans on this site
- Aspire Health Advantage (HMO) — Offered in CA: Monterey
- Aspire Health Plus (HMO-POS) — Offered in CA: Monterey
- Aspire Health Protect (HMO) — Offered in CA: Monterey
- Aspire Health Value (HMO) — Offered in CA: Monterey
Blue Cross and Blue Shield of Nebraska
3 plans on this site
- Blue Cross and Blue Shield of Nebraska MA Assure (HMO-POS) — Offered in NE: 61 counties
- Blue Cross and Blue Shield of Nebraska MA Connect (PPO) — Offered in NE: 61 counties
- Blue Cross and Blue Shield of Nebraska MA Protect (PPO) — Offered in NE: 61 counties
CenCal CareConnect
1 plan on this site
- CenCal CareConnect (HMO D-SNP) — Offered in CA: San Luis Obispo, Santa Barbara
Cox HealthPlans
3 plans on this site
- CMH Medicare Advantage (HMO) — Offered in MO: Cedar, Dade, Dallas, Hickory, Polk
- CoxHealth Medicare Advantage (HMO) — Offered in MO: Barry, Christian, Greene, Lawrence, Stone, Taney, Webster
- Phelps Health Medicare Advantage (HMO) — Offered in MO: Crawford, Dent, Maries, Phelps, Pulaski
Elite Health Plan, Inc.
2 plans on this site
- Elite Core HMO (HMO) — Offered in CA: Los Angeles, Riverside, San Bernardino
- Elite Signature HMO (HMO) — Offered in CA: Los Angeles, Riverside, San Bernardino
Florida Blue
2 plans on this site
- BlueMedicare Select (PPO) — Offered in FL: 25 counties
- BlueMedicare Value (PPO) — Offered in FL: 12 counties
Florida Blue HMO
5 plans on this site
- BlueMedicare Classic (HMO) — Offered in FL: 21 counties
- BlueMedicare Focus (HMO C-SNP) — Offered in FL: Charlotte, Collier, Lee, Manatee, Sarasota
- BlueMedicare Preferred (HMO) — Offered in FL: Hillsborough, Polk
- FHCP Medicare Classic (HMO) — Offered in FL: Brevard, Flagler, St. Johns, Volusia
- FHCP Medicare Rx Plus (HMO) — Offered in FL: Flagler, Volusia
GlobalHealth
6 plans on this site
- Generations Chronic Care (HMO C-SNP) — Offered in OK: 26 counties
- Generations Chronic Care Savings (HMO C-SNP) — Offered in OK: 26 counties
- Generations Classic Plus (HMO) — Offered in OK: 26 counties
- Generations Classic Rewards (HMO) — Offered in OK: 26 counties
- Generations Dual Premier (HMO D-SNP) — Offered in OK: 26 counties
- Generations Dual Support (HMO D-SNP) — Offered in OK: 26 counties
Health Alliance Plan by Henry Ford Health
12 plans on this site
- HAP Medicare Complete Assist (PPO D-SNP) — Offered in MI: 40 counties
- HAP Medicare Complete Duals (HMO D-SNP) — Offered in MI: 39 counties
- HAP Medicare Connect (HMO) — Offered in MI: 61 counties
- HAP Medicare Diabetes and Heart (HMO C-SNP) — Offered in MI: 61 counties
- HAP Medicare Explore (PPO) — Offered in MI: 60 counties
- HAP Medicare Prime (PPO) — Offered in MI: 60 counties
- HAP Medicare Superior (HMO) — Offered in MI: 61 counties
- HAP Member Assist (PPO) — Offered in MI: 60 counties
- HAP Senior Plus (HMO-POS) — Offered in MI: 61 counties
- HAP Senior Plus (PPO) — Offered in MI: 60 counties
- HAP Senior Plus Henry Ford Tiered Access (HMO) — Offered in MI: Genesee, Hillsdale, Jackson, Lapeer, Macomb, Oakland, Wayne
- Henry Ford Select (HMO) — Offered in MI: Genesee, Hillsdale, Jackson, Lapeer, Macomb, Oakland, Wayne
Imperial Health Plan of California, Inc.
3 plans on this site
- Imperial Dynamic Plan (HMO) — Offered in CA: 51 counties
- Imperial Flex (HMO C-SNP) — Offered in CA: 51 counties
- Imperial Senior Value (HMO C-SNP) — Offered in CA: 51 counties
MedCare Partners Health Plan of Texas
3 plans on this site
- MedCare Choice (HMO C-SNP) — Offered in TX: Harris
- MedCare Classic (HMO) — Offered in TX: Harris
- MedCare Focus (HMO C-SNP) — Offered in TX: Harris
Priority Health Medicare
12 plans on this site
- PriorityMedicare (HMO-POS) — Offered in MI: 18 counties
- PriorityMedicare Align (HMO-POS) — Offered in MI: 13 counties
- PriorityMedicare D-SNP (HMO D-SNP) — Offered in MI: 58 counties
- PriorityMedicare Dual Premier (HMO D-SNP) — Offered in MI: Berrien, Calhoun, Cass, Kalamazoo, Van Buren
- PriorityMedicare Edge (PPO) — Offered in MI: 13 counties
- PriorityMedicare Key (HMO-POS) — Offered in MI: 13 counties
- PriorityMedicare Latitude (HMO-POS) — Offered in MI: 19 counties
- PriorityMedicare Merit (PPO) — Offered in MI: 18 counties
- PriorityMedicare Smart Savings (HMO-POS) — Offered in MI: 18 counties
- PriorityMedicare Thrive (PPO) — Offered in MI: 13 counties
- PriorityMedicare Thrive Plus (PPO) — Offered in MI: 13 counties
- PriorityMedicare Value (HMO-POS) — Offered in MI: 18 counties
San Francisco Health Plan
1 plan on this site
- SFHP Care Plus (HMO D-SNP) — Offered in CA: San Francisco
SummaCare Medicare Advantage Plans
5 plans on this site
- SummaCare Medicare Emerald (HMO-POS) — Offered in OH: 15 counties
- SummaCare Medicare Quartz (HMO) — Offered in OH: 25 counties
- SummaCare Medicare Ruby (HMO) — Offered in OH: 25 counties
- SummaCare Medicare Sapphire (HMO-POS) — Offered in OH: 31 counties
- SummaCare Medicare Topaz (HMO) — Offered in OH: 25 counties
Verda Health Plan of Texas
2 plans on this site
- Verda Noble Care (HMO) — Offered in TX: Collin, Dallas, Denton, Tarrant
- Verda Noble Chronic Care (HMO C-SNP) — Offered in TX: Collin, Dallas, Denton, Tarrant
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage.
Source: CMS Prescription Drug Plan Formulary data + this site's published plan records · List built 2026-11-08