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Medications
Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy) — plans on this site that list it on Tier 3
70 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.
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
Geisinger Gold
9 plans on this site
- Geisinger Gold Classic 360 Rx (HMO) — Offered in PA: 19 counties
- Geisinger Gold Classic Advantage Rx (HMO) — Offered in PA: 21 counties
- Geisinger Gold Classic Complete Rx (HMO) — Offered in PA: 37 counties
- Geisinger Gold Classic Essential Rx (HMO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Advantage Rx (PPO) — Offered in PA: 29 counties
- Geisinger Gold Preferred Balance Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Complete Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Secure Rx (HMO D-SNP) — Offered in PA: 63 counties
- Geisinger Gold Value Rx (HMO) — Offered in PA: 63 counties
Gold Coast Health Plan
1 plan on this site
- Gold Coast Health Plan Total Care Advantage (HMO D-SNP) — Offered in CA: Ventura
HealthSpring
15 plans on this site
- HealthSpring Achieve (HMO C-SNP) — Offered in MS: 12 counties
- HealthSpring Achieve Savings (HMO C-SNP) — Offered in AL: Chilton, Jefferson, Shelby, Talladega, Walker
- HealthSpring Alliance (HMO) — Offered in TX: 11 counties
- HealthSpring Preferred (HMO) — Offered in TN: 31 counties
- HealthSpring Preferred Extra Savings (HMO) — Offered in TX: 18 counties
- HealthSpring Preferred GA (HMO) — Offered in GA: 12 counties
- HealthSpring Preferred PA (HMO) — Offered in PA: Bucks, Chester, Delaware, Montgomery, Philadelphia
- HealthSpring Preferred Plus (HMO) — Offered in MS: 20 counties
- HealthSpring Preferred Savings (HMO) — Offered in KY: Boone, Campbell, Grant, Kenton, Pendleton; OH: 13 counties
- HealthSpring Premier (HMO-POS) — Offered in TN: 59 counties
- HealthSpring Primary (HMO) — Offered in TN: 25 counties
- HealthSpring TotalCare (HMO D-SNP) — Offered in AR: 43 counties
- HealthSpring TotalCare Plus (HMO D-SNP) — Offered in TN: 62 counties
- HealthSpring True Choice (PPO) — Offered in GA: Catoosa, Dade, Walker; MS: DeSoto, Marshall, Tate, Tunica; TN: 78 counties
- HealthSpring True Choice Savings (PPO) — Offered in IL: Cook, DuPage, Kane, Kankakee, Will
Quartz Medicare Advantage (HMO)
14 plans on this site
- Gundersen MN Quartz Med Advantage Basic D (w/Rx) (HMO) — Offered in MN: Fillmore, Houston, Wabasha
- Gundersen MN Quartz Med Advantage Core D (w/Rx) (HMO) — Offered in MN: Fillmore, Houston, Wabasha
- Gundersen MN Quartz Med Advantage Elite D (w/Rx) (HMO) — Offered in MN: Fillmore, Houston, Wabasha
- Gundersen MN Quartz Med Advantage Value D (w/Rx) (HMO) — Offered in MN: Fillmore, Houston, Wabasha
- Gundersen Quartz Med Advantage Basic D (w/Rx) (HMO) — Offered in IA: Allamakee, Fayette, Winneshiek; WI: Buffalo, La Crosse, Monroe, Pepin, Trempealeau
- Gundersen Quartz Med Advantage Core D (w/Rx) (HMO) — Offered in IA: Allamakee, Fayette, Winneshiek; WI: Buffalo, La Crosse, Monroe, Pepin, Trempealeau
- Gundersen Quartz Med Advantage Dual Eligible (HMO D-SNP) — Offered in WI: La Crosse
- Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO) — Offered in IA: Allamakee, Fayette, Winneshiek; WI: Buffalo, La Crosse, Monroe, Pepin, Trempealeau
- Gundersen Quartz Med Advantage Value D (w/Rx) (HMO) — Offered in IA: Allamakee, Fayette, Winneshiek; WI: Buffalo, La Crosse, Monroe, Pepin, Trempealeau
- UW Health Quartz Med Advantage Basic D (w/Rx) (HMO) — Offered in WI: Columbia, Dane, Green
- UW Health Quartz Med Advantage Core D (w/Rx) (HMO) — Offered in WI: Columbia, Dane, Green
- UW Health Quartz Med Advantage Dual Eligible (HMO D-SNP) — Offered in WI: Dane
- UW Health Quartz Med Advantage Elite D (w/Rx) (HMO) — Offered in WI: Columbia, Dane, Green
- UW Health Quartz Med Advantage Value D (w/Rx) (HMO) — Offered in WI: Columbia, Dane, Green
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
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
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