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Medications
Loperamide (Imodium and others) — plans on this site that list it on Tier 3
36 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.
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
Blue Cross Blue Shield of Arizona (AZ Blue)
1 plan on this site
- Blue Best Life Select (HMO) — Offered in AZ: Maricopa, Pinal
Blue Cross and Blue Shield of Nebraska
3 plans on this site
- Blue Cross and Blue Shield of Nebraska MA Assure (HMO-POS) — Offered in NE: 61 counties
- Blue Cross and Blue Shield of Nebraska MA Connect (PPO) — Offered in NE: 61 counties
- Blue Cross and Blue Shield of Nebraska MA Protect (PPO) — Offered in NE: 61 counties
Florida Blue
2 plans on this site
- BlueMedicare Select (PPO) — Offered in FL: 25 counties
- BlueMedicare Value (PPO) — Offered in FL: 12 counties
Florida Blue HMO
5 plans on this site
- BlueMedicare Classic (HMO) — Offered in FL: 21 counties
- BlueMedicare Focus (HMO C-SNP) — Offered in FL: Charlotte, Collier, Lee, Manatee, Sarasota
- BlueMedicare Preferred (HMO) — Offered in FL: Hillsborough, Polk
- FHCP Medicare Classic (HMO) — Offered in FL: Brevard, Flagler, St. Johns, Volusia
- FHCP Medicare Rx Plus (HMO) — Offered in FL: Flagler, Volusia
Samaritan Advantage Health Plans
1 plan on this site
- Samaritan Dual Advantage (HMO D-SNP) — Offered in OR: Benton, Lincoln, Linn
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
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
