Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy) — plans on this site that list it on Tier 4

BayCare Health Plans

2 plans on this site

• BayCarePlus Complete (HMO) — Offered in FL: Hillsborough, Pasco, Pinellas, Polk
• BayCarePlus Rewards (HMO) — Offered in FL: Hillsborough, Pasco, Pinellas, Polk

Healthy Arkansas, Inc.

3 plans on this site

• Healthy Arkansas Dual Advantage (PPO D-SNP) — Offered in AR: 35 counties
• Healthy Arkansas Preferred (PPO) — Offered in AR: 35 counties
• Healthy Arkansas Premier Advantage (HMO-POS) — Offered in AR: 35 counties

Healthy Mississippi, Inc.

4 plans on this site

• Healthy Mississippi Dual Advantage (PPO D-SNP) — Offered in MS: 81 counties
• Healthy Mississippi Institutional (PPO I-SNP) — Offered in MS: 81 counties
• Healthy Mississippi Preferred (PPO) — Offered in MS: 81 counties
• Healthy Mississippi Premier Advantage (HMO-POS) — Offered in MS: 81 counties

Presbyterian Health Plan

1 plan on this site

• Presbyterian Dual Plus (HMO D-SNP) — Offered in NM: 20 counties

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

Select Health

4 plans on this site

• Select Health Medicare Dual (HMO D-SNP) — Offered in UT: Davis, Iron, Salt Lake, Utah, Washington, Weber
• Select Health Medicare Essential (HMO) — Offered in CO: Adams, Arapahoe, Denver, Douglas, El Paso, Elbert, Jefferson, Pueblo, Teller
• Select Health Medicare Value Giveback (HMO) — Offered in NV: Clark, Nye
• Select Health Medicare Wellness (HMO) — Offered in NV: Clark, Nye

Tufts Health Plan

6 plans on this site

• Tufts Medicare Preferred HMO Basic Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
• Tufts Medicare Preferred HMO Prime Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
• Tufts Medicare Preferred HMO Prime Rx Plus (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
• Tufts Medicare Preferred HMO Smart Saver Rx (HMO) — Offered in MA: Bristol, Essex, Norfolk, Plymouth, Suffolk
• Tufts Medicare Preferred HMO Value Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
• Tufts Medicare Preferred PPO RX (PPO) — Offered in MA: Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester