Medications
Bosentan (Tracleer) — 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.
Freedom Health, Inc.
10 plans on this site
- Freedom Medi-Medi Full (HMO D-SNP) — Offered in FL: Brevard
- Freedom Medi-Medi Partial (HMO D-SNP) — Offered in FL: 24 counties
- Freedom Medicare Plan Rx (HMO) — Offered in FL: Brevard, Charlotte, Lee, Pinellas, Volusia
- Freedom Máximo (HMO-POS) — Offered in FL: Orange, Osceola, Seminole
- Freedom Platinum Plan Rx (HMO) — Offered in FL: Charlotte, Collier, Lee, Manatee, Sarasota
- Freedom Platinum Rewards Plan Rx (HMO) — Offered in FL: Orange, Osceola, Seminole, Volusia
- Freedom VIP Care (HMO C-SNP) — Offered in FL: 16 counties
- Freedom VIP Rewards (HMO C-SNP) — Offered in FL: Brevard, Indian River, Martin, St. Lucie
- Freedom VIP Savings (HMO C-SNP) — Offered in FL: 16 counties
- Freedom VIP Savings COPD (HMO C-SNP) — Offered in FL: 16 counties
Geisinger Gold
9 plans on this site
- Geisinger Gold Classic 360 Rx (HMO) — Offered in PA: 19 counties
- Geisinger Gold Classic Advantage Rx (HMO) — Offered in PA: 21 counties
- Geisinger Gold Classic Complete Rx (HMO) — Offered in PA: 37 counties
- Geisinger Gold Classic Essential Rx (HMO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Advantage Rx (PPO) — Offered in PA: 29 counties
- Geisinger Gold Preferred Balance Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Complete Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Secure Rx (HMO D-SNP) — Offered in PA: 63 counties
- Geisinger Gold Value Rx (HMO) — Offered in PA: 63 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
Independent Health
6 plans on this site
- Independent Health's Assure Advantage (HMO C-SNP) — Offered in NY: Erie
- Independent Health's Encompass 65 RED 042 (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Encompass 65 RED 044 (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Encompass 65 RED 045 (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Medicare Family Choice (HMO I-SNP) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Medicare Passport Connect (PPO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
Jefferson Health Plans
10 plans on this site
- Jefferson Health Plans Complete (HMO) — Offered in PA: 20 counties
- Jefferson Health Plans Dual Pearl (HMO D-SNP) — Offered in PA: 22 counties
- Jefferson Health Plans Elite (HMO) — Offered in NJ: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Mercer, Salem
- Jefferson Health Plans Flex (PPO) — Offered in PA: 20 counties
- Jefferson Health Plans Giveback (HMO) — Offered in PA: 20 counties
- Jefferson Health Plans Preferred (PPO) — Offered in PA: 20 counties
- Jefferson Health Plans Premier (PPO) — Offered in NJ: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Mercer, Salem
- Jefferson Health Plans Prime (HMO) — Offered in PA: 20 counties
- Jefferson Health Plans Select (HMO D-SNP) — Offered in PA: 20 counties
- Jefferson Health Plans Special (HMO D-SNP) — Offered in PA: 42 counties
Leon Health, Inc.
4 plans on this site
- Leon MediDual (HMO D-SNP) — Offered in FL: Miami-Dade
- Leon MediExtra (HMO) — Offered in FL: Miami-Dade
- Leon MediMax (HMO D-SNP) — Offered in FL: Miami-Dade
- Leon MediMore (HMO) — Offered in FL: Miami-Dade
Optimum HealthCare, Inc.
11 plans on this site
- Optimum Diamond (HMO C-SNP) — Offered in FL: Citrus, Hernando, Hillsborough, Pasco, Pinellas
- Optimum Diamond Rewards (HMO C-SNP) — Offered in FL: Citrus, Hernando, Hillsborough, Pasco, Pinellas
- Optimum Diamond Rewards COPD (HMO C-SNP) — Offered in FL: Citrus, Hernando, Hillsborough, Pasco, Pinellas
- Optimum Diamond Savings (HMO C-SNP) — Offered in FL: 18 counties
- Optimum Diamond Savings COPD (HMO C-SNP) — Offered in FL: 14 counties
- Optimum Emerald Full (HMO D-SNP) — Offered in FL: Collier
- Optimum Emerald Partial (HMO D-SNP) — Offered in FL: 24 counties
- Optimum Gold Plan (HMO) — Offered in FL: Citrus, Polk, Sarasota
- Optimum Gold Plus Plan (HMO) — Offered in FL: Citrus, Hernando
- Optimum Gold Rewards Plan (HMO) — Offered in FL: Broward, Citrus, Hernando, Hillsborough, Pasco, Pinellas
- Optimum Platinum Plan (HMO) — Offered in FL: Broward, Citrus, Hernando, Hillsborough, Pasco, Pinellas
Sentara Medicare
2 plans on this site
- Sentara Community Complete (HMO D-SNP) — Offered in VA: 133 counties
- Sentara Community Complete Select (HMO D-SNP) — Offered in VA: 133 counties
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