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Butalbital / acetaminophen / caffeine (Fioricet, Esgic, and others) — plans on this site that list it on Tier 3

964 plans published on this site list this drug on Tier 3, grouped by company. Plans are sold by county — the service area under each plan shows where it is offered.

Align powered by Sanford Health Plan

2 plans on this site

Alignment Health Plan

72 plans on this site

AlohaCare

1 plan on this site

AmeriHealth

2 plans on this site

AmeriHealth Caritas VIP Care (HMO-D-SNP)

1 plan on this site

Anthem Blue Cross

5 plans on this site

Anthem Blue Cross Partnership Plan

4 plans on this site

Anthem HealthKeepers

1 plan on this site

BayCare Health Plans

2 plans on this site

Baylor Scott & White Health Plan

6 plans on this site

Blue Cross & Blue Shield of Rhode Island

5 plans on this site

Blue Cross Blue Shield of Arizona (AZ Blue)

2 plans on this site

Blue Cross Blue Shield of South Carolina

2 plans on this site

Blue Cross and Blue Shield of Alabama

3 plans on this site

Blue Cross and Blue Shield of IL, NM

4 plans on this site

Blue Cross and Blue Shield of Kansas

3 plans on this site

Blue Cross and Blue Shield of Minnesota

3 plans on this site

Blue Cross and Blue Shield of North Carolina

5 plans on this site

Blue Plus

1 plan on this site

Blue Shield of California

9 plans on this site

Capital Blue Cross

4 plans on this site

Capital Health Plan

4 plans on this site

Clover Health

8 plans on this site

EmblemHealth

5 plans on this site

First Choice VIP Care (HMO D-SNP)

1 plan on this site

Florida Blue HMO

1 plan on this site

Florida Complete Care

3 plans on this site

Gold Coast Health Plan

1 plan on this site

Great Plains Medicare Advantage

3 plans on this site

HealthPartners

5 plans on this site

Healthy Arkansas, Inc.

3 plans on this site

Healthy Mississippi, Inc.

4 plans on this site

Independence Blue Cross

8 plans on this site

KelseyCare Advantage

2 plans on this site

MyAdvocate Medicare Advantage

2 plans on this site

Network Health Medicare Advantage Plans

7 plans on this site

Peoples Health

11 plans on this site

PrimeTime Health Plan

3 plans on this site

Quartz Medicare Advantage (HMO)

14 plans on this site

Regence BlueCross BlueShield of Oregon

3 plans on this site

Regence BlueShield

1 plan on this site

Security Health Plan of Wisconsin, Inc.

4 plans on this site

Select Health

4 plans on this site

Solis Health Plans

5 plans on this site

South Country Health Alliance

2 plans on this site

St. Luke's Health Plan

3 plans on this site

Ultimate Health Plans

5 plans on this site

UnitedHealthcare

696 plans on this site

VISTA Health Plan Inc.

2 plans on this site

Wellpoint

11 plans on this site

eternalHealth

6 plans on this site

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

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