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Medications
Cysteamine (Procysbi / Cystagon / Cystaran / Cystadrops) — plans on this site that list it on Tier 5
35 plans published on this site list this drug on Tier 5, grouped by company. Plans are sold by county — the service area under each plan shows where it is offered.
CDPHP Medicare Advantage
3 plans on this site
- CDPHP $0 Medicare Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
- CDPHP Choice Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
- CDPHP Clear Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
Excellus Health Plan Community Care LLC
4 plans on this site
- Medicare Blue Dual (HMO D-SNP) — Offered in NY: 11 counties
- Medicare Blue Dual Secure (HMO D-SNP) — Offered in NY: 11 counties
- Univera Medicare Dual (HMO D-SNP) — Offered in NY: Erie, Orleans
- Univera Medicare Total Care (HMO D-SNP) — Offered in NY: Erie, Orleans
Excellus Health Plan, Inc
14 plans on this site
- Medicare Blue Choice 024 (HMO) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 025 (HMO-POS) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 026 (HMO-POS) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 028 (HMO) — Offered in NY: 13 counties
- Medicare Blue Choice 029 (HMO-POS) — Offered in NY: 13 counties
- Medicare Blue Choice 030 (HMO-POS) — Offered in NY: 13 counties
- Medicare Blue Choice 032 (HMO-POS) — Offered in NY: Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Montgomery, Otsego
- Medicare Blue Choice Core (HMO) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Medicare Blue Choice Optimum (HMO-POS) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Medicare Blue Choice Prime (HMO-POS) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Univera SeniorChoice Advanced (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Basic (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Secure (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Value Plus (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
PrimeTime Health Plan
3 plans on this site
- PrimeTime Health Plan Aultimate (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
- PrimeTime Health Plan Classic (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
- PrimeTime Health Plan Plus (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
Prominence Health Plan
11 plans on this site
- Prominence Beyond (HMO-POS) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Bridge (HMO D-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Diabetes and Heart (HMO C-SNP) — Offered in NV: Washoe
- Prominence Diabetes and Heart Care Plus (HMO C-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Diabetes and Heart Giveback (HMO C-SNP) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Dual (HMO D-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Extra Help (HMO) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Giveback (HMO) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Meridian (HMO-POS) — Offered in NV: Washoe
- Prominence Plus (HMO) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Silver Peak (HMO) — Offered in NV: Carson City, Churchill, Douglas, Lyon, Storey
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
