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Medications
Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy) — plans on this site that list it on Tier 1
25 plans published on this site list this drug on Tier 1, grouped by company. Plans are sold by county — the service area under each plan shows where it is offered.
CalOptima Health OneCare
1 plan on this site
- CalOptima Health OneCare Complete (HMO D-SNP) — Offered in CA: Orange
Commonwealth Care Alliance Massachusetts
1 plan on this site
- CCA Senior Care Options (HMO D-SNP) — Offered in MA: Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
Commonwealth Care Alliance, Inc.
1 plan on this site
- CCA One Care (HMO D-SNP) — Offered in MA: 12 counties
Community Care
1 plan on this site
- Community Care's Partnership Program (HMO D-SNP) — Offered in WI: Calumet, Kenosha, Outagamie, Ozaukee, Racine, Washington, Waukesha, Waupaca
Elderplan
3 plans on this site
- Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) — Offered in NY: 18 counties
- Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) — Offered in NY: Bronx, Kings, Nassau, New York, Putnam, Queens, Richmond, Westchester
- Elderplan Plus Long-Term Care (HMO-POS D-SNP) — Offered in NY: 11 counties
Fallon Health
2 plans on this site
- NaviCare (HMO D-SNP) — Offered in MA: 12 counties
- NaviCare NHC (HMO D-SNP) — Offered in MA: 12 counties
HEALTH PLAN OF SAN MATEO
1 plan on this site
- CareAdvantage (HMO D-SNP) — Offered in CA: San Mateo
HMSA Akamai Advantage Dual Care
1 plan on this site
- HMSA Akamai Advantage Dual Care (PPO D-SNP) — Offered in HI: Hawaii, Honolulu, Kalawao, Kauai, Maui
Healthfirst Medicare Plan
1 plan on this site
- Healthfirst CompleteCare (HMO D-SNP) — Offered in NY: Bronx, Kings, Nassau, New York, Orange, Queens, Richmond, Rockland, Sullivan, Westchester
Johns Hopkins Advantage MD
2 plans on this site
- Johns Hopkins Advantage MD BMORE Balanced (HMO D-SNP) — Offered in MD: Baltimore City
- Johns Hopkins Advantage MD D-SNP (HMO D-SNP) — Offered in MD: Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico, Worcester
Mass General Brigham Health Plan
2 plans on this site
- Mass General Brigham One Care (HMO D-SNP) — Offered in MA: Bristol, Dukes, Essex, Middlesex, Nantucket, Norfolk, Plymouth, Suffolk
- Mass General Brigham SCO (HMO D-SNP) — Offered in MA: Bristol, Dukes, Essex, Middlesex, Nantucket, Norfolk, Plymouth, Suffolk
Mercy Care Advantage
1 plan on this site
- Mercy Care Advantage (HMO D-SNP) — Offered in AZ: 15 counties
MetroPlus Health Plan
2 plans on this site
- MetroPlus Platinum Plan (HMO) — Offered in NY: Bronx, Kings, New York, Queens, Richmond
- MetroPlus UltraCare (HMO D-SNP) — Offered in NY: Bronx, Kings, New York, Queens, Richmond
Tufts Health Plan
4 plans on this site
- Tufts Health One Care (HMO D-SNP) — Offered in MA: Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- Tufts Health One Care CW (HMO D-SNP) — Offered in MA: Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- Tufts Health Plan Senior Care Options (HMO D-SNP) — Offered in MA: Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- Tufts Health Plan Senior Care Options CW (HMO D-SNP) — Offered in MA: Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
VIVA Medicare
2 plans on this site
- VIVA Medicare Extra Care (HMO D-SNP) — Offered in AL: Jackson, Limestone, Madison, Marshall, Morgan
- VIVA Medicare Extra Value (HMO D-SNP) — Offered in AL: 31 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