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Medications
Levofloxacin (Levaquin and others) — plans on this site that list it on Tier 4
13 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.
Anthem HealthKeepers
1 plan on this site
- Anthem Medicare Advantage 3 (HMO-POS) — Offered in VA: 50 counties
UPMC for Life
11 plans on this site
- UPMC for Life Essential Rx (PPO) — Offered in PA: 34 counties
- UPMC for Life HMO Deductible Rx (HMO) — Offered in OH: Harrison, Jefferson; PA: 17 counties
- UPMC for Life HMO Premier Rx (HMO) — Offered in PA: 18 counties
- UPMC for Life HMO Rx (HMO) — Offered in OH: Harrison, Jefferson; PA: 31 counties
- UPMC for Life HMO Rx Choice (HMO) — Offered in PA: 18 counties
- UPMC for Life HMO Rx Enhanced (HMO) — Offered in OH: Harrison, Jefferson; PA: 39 counties
- UPMC for Life PPO High Deductible Rx (PPO) — Offered in PA: 17 counties
- UPMC for Life PPO Premier Rx (PPO) — Offered in PA: 13 counties
- UPMC for Life PPO Rx Choice (PPO) — Offered in PA: Armstrong, Beaver, Fayette, Greene, Lawrence, Washington
- UPMC for Life PPO Rx Enhanced (PPO) — Offered in PA: 18 counties
- UPMC for Life Preferred Rx (HMO) — Offered in PA: Butler, Clarion, Westmoreland
UPMC for Life Complete Care
1 plan on this site
- UPMC for Life Complete Care (HMO D-SNP) — Offered in PA: 26 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