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Levomilnacipran (Fetzima) — plans on this site that list it on Tier 3

108 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.

AHF

1 plan on this site

Banner Medicare Advantage

1 plan on this site

Blue Cross and Blue Shield of Louisiana

8 plans on this site

BlueCare Plus Tennessee

3 plans on this site

BlueCross BlueShield of Tennessee

8 plans on this site

Essence Healthcare

7 plans on this site

Freedom Health, Inc.

10 plans on this site

HAP CareSource MI Coordinated Health

1 plan on this site

HealthSun Health Plans, Inc.

6 plans on this site

HealthTeam Advantage

4 plans on this site

Leon Health, Inc.

4 plans on this site

MCS Classicare

16 plans on this site

Medica

1 plan on this site

Medicare y Mucho Mas (MMM)

16 plans on this site

Optimum HealthCare, Inc.

11 plans on this site

Sentara Medicare

2 plans on this site

Simply Healthcare Plans, Inc.

2 plans on this site

The Health Plan

4 plans on this site

Upper Peninsula Health Plan (UPHP) MI Coordinated Health

1 plan on this site

VNS Health Medicare

2 plans on this site

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

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