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Cevimeline (Evoxac) — plans on this site that list it on Tier 4

941 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.

AMH Health

5 plans on this site

Aetna Medicare

121 plans on this site

Alignment Health Plan

72 plans on this site

Allina Health Aetna Medicare

7 plans on this site

AmeriHealth

2 plans on this site

Anthem Blue Cross

2 plans on this site

Anthem Blue Cross Partnership Plan

1 plan on this site

Anthem Blue Cross and Blue Shield

24 plans on this site

Anthem Blue Cross and Blue Shield HP

2 plans on this site

Anthem HealthKeepers

5 plans on this site

Astiva Health

8 plans on this site

Banner Medicare Advantage

1 plan on this site

Baylor Scott & White Health Plan

6 plans on this site

Blue Cross and Blue Shield of Alabama

2 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 Louisiana

8 plans on this site

Blue Plus

1 plan on this site

Blue Shield of California

9 plans on this site

Capital Blue Cross

10 plans on this site

Capital Health Plan

2 plans on this site

CareFirst BlueCross BlueShield Advantage DualPrime

1 plan on this site

CareOregon Advantage

1 plan on this site

CenCal CareConnect

1 plan on this site

Contra Costa Health Care Plus (HMO D-SNP)

1 plan on this site

Cox HealthPlans

3 plans on this site

Devoted Health

407 plans on this site

Doctors HealthCare Plans, Inc.

9 plans on this site

Elite Health Plan, Inc.

2 plans on this site

Essence Healthcare

7 plans on this site

Geisinger Gold

9 plans on this site

Gold Coast Health Plan

1 plan on this site

HAP CareSource MI Coordinated Health

1 plan on this site

Health First Health Plans, Inc.

6 plans on this site

HealthPartners

5 plans on this site

HealthSpring

15 plans on this site

HealthTeam Advantage

4 plans on this site

Healthy Blue

3 plans on this site

Highmark Blue Cross Blue Shield

3 plans on this site

Highmark Blue Cross Blue Shield or Highmark Blue Shield

5 plans on this site

Highmark Wholecare Medicare Assured

2 plans on this site

Imperial Health Plan of California, Inc.

3 plans on this site

Independence Blue Cross

8 plans on this site

Itasca Medical Care/IMCare Classic

1 plan on this site

Jefferson Health Plans

10 plans on this site

Kern Family Health Care Medicare (D-SNP)

1 plan on this site

L.A. Care Health Plan

1 plan on this site

MVP HEALTH CARE

7 plans on this site

Martin's Point Generations Advantage

2 plans on this site

MedCare Partners Health Plan of Texas

3 plans on this site

MediGold

8 plans on this site

Medica

1 plan on this site

MetroPlus Health Plan

1 plan on this site

Molina Healthcare of Illinois

1 plan on this site

Molina Healthcare of Massachusetts

3 plans on this site

Molina Healthcare of Michigan

1 plan on this site

Molina Healthcare of Ohio

2 plans on this site

Molina Healthcare of Texas, Inc.

1 plan on this site

Molina Healthcare of Washington, Inc.

1 plan on this site

Molina Healthcare of Wisconsin

2 plans on this site

Neighborhood Health Plan of Rhode Island

2 plans on this site

Passport Advantage

1 plan on this site

Presbyterian Health Plan

1 plan on this site

PrimeTime Health Plan

3 plans on this site

Priority Health Medicare

12 plans on this site

Regence BlueCross BlueShield of Oregon

3 plans on this site

Regence BlueShield

1 plan on this site

San Francisco Health Plan

1 plan on this site

Senior Whole Health of New York

2 plans on this site

Solis Health Plans

5 plans on this site

SummaCare Medicare Advantage Plans

5 plans on this site

The Health Plan

4 plans on this site

Trinity Health Plan New York

2 plans on this site

Trinity Health Plan of Michigan

3 plans on this site

Troy Medicare

2 plans on this site

Tufts Health Plan

6 plans on this site

UCLA Health Medicare Advantage Plan

2 plans on this site

UPMC for Life

11 plans on this site

UPMC for Life Complete Care

1 plan on this site

Upper Peninsula Health Plan (UPHP) MI Coordinated Health

1 plan on this site

VIVA Medicare

5 plans on this site

Verda Health Plan of Texas

2 plans on this site

VillageCareMAX

3 plans on this site

Wellpoint

19 plans on this site

Zing Health

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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