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Medications
Brimonidine eye drops (Alphagan P and others) — plans on this site that list it on Tier 4
83 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.
Baylor Scott & White Health Plan
6 plans on this site
- BSW SeniorCare Advantage (PPO) — Offered in TX: Collin, Dallas, Denton, Ellis, Johnson, Rockwall, Tarrant
- BSW SeniorCare Advantage Basic (PPO) — Offered in TX: 29 counties
- BSW SeniorCare Advantage Platinum (PPO) — Offered in TX: 29 counties
- BSW SeniorCare Advantage Preferred Rx (HMO-POS) — Offered in TX: 34 counties
- BSW SeniorCare Advantage Premium Rx (HMO-POS) — Offered in TX: 34 counties
- BSW SeniorCare Advantage Select Rx (HMO-POS) — Offered in TX: 34 counties
Blue Cross and Blue Shield of Alabama
2 plans on this site
- Blue Advantage Complete (PPO) — Offered in AL: 60 counties
- Blue Advantage Core (PPO) — Offered in AL: Baldwin, Bibb, Chilton, Jefferson, Mobile, Shelby, Walker
Blue Cross and Blue Shield of IL, NM
4 plans on this site
- Blue Cross Medicare Advantage Basic (HMO-POS) — Offered in IL: Cook, DuPage, Kane, Will
- Blue Cross Medicare Advantage Dual Care (HMO-POS D-SNP) — Offered in NM: 33 counties
- Blue Cross Medicare Advantage Dual Care Plus (HMO-POS D-SNP) — Offered in NM: 33 counties
- Blue Cross Medicare Advantage Select (HMO-POS) — Offered in IL: DuPage, Kane
Blue Cross and Blue Shield of Kansas
3 plans on this site
- Blue Medicare Advantage (PPO) — Offered in KS: Jackson, Lyon, Osage, Pottawatomie, Shawnee, Wabaunsee
- Blue Medicare Advantage Choice (PPO) — Offered in KS: Jackson, Lyon, Osage, Pottawatomie, Shawnee, Wabaunsee
- Blue Medicare Advantage Comprehensive (PPO) — Offered in KS: Jackson, Lyon, Osage, Pottawatomie, Shawnee, Wabaunsee
Blue Plus
1 plan on this site
- SecureBlue (HMO D-SNP) — Offered in MN: 55 counties
Capital Blue Cross
4 plans on this site
- Capital Blue Cross Classic (PPO) — Offered in PA: 21 counties
- Capital Blue Cross Premier (HMO) — Offered in PA: 21 counties
- Capital Blue Cross Prime (PPO) — Offered in PA: 21 counties
- Capital Blue Cross Value (HMO) — Offered in PA: Centre, Dauphin, Juniata, Mifflin, Perry
Capital Health Plan
2 plans on this site
- Capital Health Plan Advantage Plus (HMO) — Offered in FL: Calhoun, Franklin, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla
- Capital Health Plan Preferred Advantage (HMO) — Offered in FL: Calhoun, Franklin, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla
CareOregon Advantage
1 plan on this site
- CareOregon Advantage Plus (HMO D-SNP) — Offered in OR: Clackamas, Columbia, Jackson, Multnomah, Washington
Gold Coast Health Plan
1 plan on this site
- Gold Coast Health Plan Total Care Advantage (HMO D-SNP) — Offered in CA: Ventura
Highmark Blue Cross Blue Shield
2 plans on this site
- Highmark Health Options Duals (HMO D-SNP) — Offered in WV: 40 counties
- Highmark Health Options Duals Select (HMO D-SNP) — Offered in DE: Kent, New Castle, Sussex
Highmark Wholecare Medicare Assured
2 plans on this site
- Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) — Offered in PA: 57 counties
- Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) — Offered in PA: 57 counties
Regence BlueCross BlueShield of Oregon
3 plans on this site
- Regence MedAdvantage + Rx Classic (PPO) — Offered in OR: Clackamas, Columbia, Lane, Marion, Multnomah, Washington, Yamhill
- Regence MedAdvantage + Rx Enhanced (PPO) — Offered in OR: Clackamas, Columbia, Lane, Marion, Multnomah, Washington, Yamhill
- Regence MedAdvantage + Rx Primary (PPO) — Offered in OR: Clackamas, Columbia, Lane, Marion, Multnomah, Washington, Yamhill
Regence BlueShield
1 plan on this site
- Regence BlueAdvantage HMO (HMO) — Offered in WA: King, Snohomish
SCAN Health Plan
32 plans on this site
- CareMore Health Plan by SCAN (HMO) — Offered in CA: Los Angeles, Orange
- SCAN Allied (HMO) — Offered in CA: San Francisco, San Mateo
- SCAN Alta (HMO) — Offered in CA: San Diego
- SCAN Ansim Care (HMO C-SNP) — Offered in CA: Los Angeles, Orange
- SCAN Baekse (HMO) — Offered in CA: Los Angeles, Orange
- SCAN Balance (HMO C-SNP) — Offered in CA: Fresno, Kings, Madera, Tulare
- SCAN Balance Texas (HMO C-SNP) — Offered in TX: Bexar, Chambers, Fort Bend, Harris, Liberty, Montgomery
- SCAN Classic (HMO) — Offered in CA: Fresno, Kings, Madera, Tulare
- SCAN Classic Texas (HMO) — Offered in TX: Bexar, Chambers, Fort Bend, Harris, Liberty, Montgomery
- SCAN Classic WA (HMO) — Offered in WA: Pierce, Spokane, Thurston
- SCAN Connections (HMO D-SNP) — Offered in CA: Los Angeles, Riverside, San Bernardino, San Diego
- SCAN Connections at Home (HMO D-SNP) — Offered in CA: Los Angeles, Riverside, San Bernardino, San Diego
- SCAN Costco Medicare Advantage (HMO) — Offered in CA: Placer, Sacramento, San Joaquin, Yolo
- SCAN Desert Choice (HMO) — Offered in CA: Riverside
- SCAN Embrace (HMO I-SNP) — Offered in CA: Los Angeles
- SCAN Embrace (HMO-POS I-SNP) — Offered in AZ: Maricopa, Pima
- SCAN Embrace Together (HMO I-SNP) — Offered in CA: Los Angeles, Orange
- SCAN Embrace Together (HMO-POS I-SNP) — Offered in AZ: Maricopa, Pima
- SCAN Essential Savings (HMO) — Offered in CA: Los Angeles
- SCAN Inclusive (HMO) — Offered in CA: Los Angeles, Orange, Riverside, San Bernardino
- SCAN Inspired by women for women (HMO) — Offered in CA: Los Angeles, Orange
- SCAN MyChoice (HMO) — Offered in AZ: Maricopa, Pima, Pinal
- SCAN Prime (HMO) — Offered in CA: Los Angeles, Orange, San Bernardino
- SCAN Select (HMO) — Offered in CA: San Diego
- SCAN Strive (HMO C-SNP) — Offered in CA: 14 counties
- SCAN Venture (HMO) — Offered in CA: Los Angeles, Orange
- SCAN Walmart Health Advantage (HMO) — Offered in TX: Bexar, Chambers, Fort Bend, Harris, Liberty, Montgomery
- SCAN Walmart Medicare Advantage (HMO) — Offered in AZ: Maricopa, Pima, Pinal
- SCAN Walmart Medicare Complete (HMO C-SNP) — Offered in TX: Bexar, Chambers, Fort Bend, Harris, Liberty, Montgomery
- Springs Advantage, a SCAN Medicare Plan (HMO-POS I-SNP) — Offered in OR: Clackamas, Washington
- Springs Together, a SCAN Medicare Plan (HMO-POS I-SNP) — Offered in OR: Clackamas, Washington
- Sutter Senior Advantage, a SCAN Medicare Plan (HMO) — Offered in CA: Placer, Sacramento, Yolo
Solis Health Plans
5 plans on this site
- Solis Balanced Plan (HMO C-SNP) — Offered in FL: Broward, Palm Beach
- Solis Guardian Plan (HMO D-SNP) — Offered in FL: Orange, Osceola, Polk, Seminole
- Solis Healthy Living Plan (HMO) — Offered in FL: Orange, Osceola, Polk, Seminole
- Solis Wellness Giveback Plan (HMO C-SNP) — Offered in FL: Orange, Osceola, Polk, Seminole
- Solis Wellness Plan (HMO C-SNP) — Offered in FL: Hillsborough, Orange, Osceola, Pasco, Pinellas, Polk, Seminole
UPMC for Life
11 plans on this site
- UPMC for Life Essential Rx (PPO) — Offered in PA: 34 counties
- UPMC for Life HMO Deductible Rx (HMO) — Offered in OH: Harrison, Jefferson; PA: 17 counties
- UPMC for Life HMO Premier Rx (HMO) — Offered in PA: 18 counties
- UPMC for Life HMO Rx (HMO) — Offered in OH: Harrison, Jefferson; PA: 31 counties
- UPMC for Life HMO Rx Choice (HMO) — Offered in PA: 18 counties
- UPMC for Life HMO Rx Enhanced (HMO) — Offered in OH: Harrison, Jefferson; PA: 39 counties
- UPMC for Life PPO High Deductible Rx (PPO) — Offered in PA: 17 counties
- UPMC for Life PPO Premier Rx (PPO) — Offered in PA: 13 counties
- UPMC for Life PPO Rx Choice (PPO) — Offered in PA: Armstrong, Beaver, Fayette, Greene, Lawrence, Washington
- UPMC for Life PPO Rx Enhanced (PPO) — Offered in PA: 18 counties
- UPMC for Life Preferred Rx (HMO) — Offered in PA: Butler, Clarion, Westmoreland
UPMC for Life Complete Care
1 plan on this site
- UPMC for Life Complete Care (HMO D-SNP) — Offered in PA: 26 counties
VillageHealth
2 plans on this site
- SCAN DaVita Dialysis Care (HMO-POS C-SNP) — Offered in CA: Orange, Riverside, San Bernardino
- SCAN DaVita Dialysis Care Complete (HMO-POS C-SNP) — Offered in CA: Los Angeles, Orange, Riverside, San Bernardino
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
