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Medications
Mexiletine (Mexitil and others) — plans on this site that list it on Tier 4
141 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.
Align powered by Sanford Health Plan
2 plans on this site
- Align SecureChoice (PPO) — Offered in IA: Lyon, O'Brien, Osceola, Sioux; ND: 17 counties; SD: 19 counties
- Align SecureChoice Gold (PPO) — Offered in IA: Lyon, O'Brien, Osceola, Sioux; ND: 17 counties; SD: 19 counties
AlohaCare
1 plan on this site
- AlohaCare Advantage Plus (HMO D-SNP) — Offered in HI: Hawaii, Honolulu, Kalawao, Kauai, Maui
AmeriHealth Caritas VIP Care (HMO-D-SNP)
1 plan on this site
- AmeriHealth Caritas VIP Care Choice (HMO D-SNP) — Offered in DE: Kent, New Castle, Sussex
Anthem HealthKeepers
1 plan on this site
- Anthem Medicare Advantage 3 (HMO-POS) — Offered in VA: 50 counties
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 Blue Shield of Arizona (AZ Blue)
3 plans on this site
- Blue Best Life Classic (HMO) — Offered in AZ: Maricopa, Pinal
- Blue Best Life Plus (HMO) — Offered in AZ: Maricopa, Pinal
- Blue Best Life Select (HMO) — Offered in AZ: Maricopa, Pinal
Blue Cross Blue Shield of South Carolina
2 plans on this site
- BlueCross Total (PPO) — Offered in SC: 12 counties
- BlueCross Total Value (PPO) — Offered in SC: 15 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 Cross and Blue Shield of North Carolina
5 plans on this site
- Blue Medicare Enhanced (HMO-POS) — Offered in NC: 42 counties
- Blue Medicare Essential (HMO) — Offered in NC: 80 counties
- Blue Medicare Essential Plus (HMO-POS) — Offered in NC: 42 counties
- Blue Medicare PPO Enhanced (PPO) — Offered in NC: 61 counties
- Healthy Blue + Medicare (HMO-POS D-SNP) — Offered in NC: 100 counties
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
CareOregon Advantage
1 plan on this site
- CareOregon Advantage Plus (HMO D-SNP) — Offered in OR: Clackamas, Columbia, Jackson, Multnomah, Washington
Clover Health
8 plans on this site
- Clover Health Choice (PPO) — Offered in NJ: 12 counties
- Clover Health Choice Giveback (PPO) — Offered in NJ: 20 counties
- Clover Health Choice Value (PPO) — Offered in NJ: 12 counties
- Clover Health Classic (HMO) — Offered in NJ: Atlantic, Bergen, Essex, Hudson, Passaic, Union
- Clover Health LiveHealthy (PPO) — Offered in GA: 151 counties
- Clover Health LiveHealthy Giveback (PPO) — Offered in GA: 139 counties; SC: 12 counties
- Clover Health LiveHealthy Premier (PPO) — Offered in GA: 151 counties
- Clover Health Value (HMO) — Offered in NJ: Atlantic, Bergen, Essex, Hudson, Middlesex, Passaic, Union
First Choice VIP Care (HMO D-SNP)
1 plan on this site
- First Choice VIP Care (HMO D-SNP) — Offered in SC: 46 counties
Gold Coast Health Plan
1 plan on this site
- Gold Coast Health Plan Total Care Advantage (HMO D-SNP) — Offered in CA: Ventura
Great Plains Medicare Advantage
3 plans on this site
- Great Plain Medicare Advantage Gold (HMO I-SNP) — Offered in IA: Fremont, Harrison, Lyon, Mills, Montgomery, Plymouth, Pottawattamie, Shelby; ND: 19 counties; SD: 23 counties
- Great Plains Medicare Advantage (HMO I-SNP) — Offered in NE: 56 counties
- Great Plains Medicare Advantage Gold (HMO I-SNP) — Offered in NE: 56 counties
HealthPartners
5 plans on this site
- HealthPartners Birch (PPO) — Offered in WI: 12 counties
- HealthPartners Cedar (PPO) — Offered in WI: 12 counties
- HealthPartners Journey Pace (PPO) — Offered in MN: Benton, Chisago, Isanti, Morrison, Sherburne, Stearns, Todd, Wright
- HealthPartners Journey Smart (PPO) — Offered in MN: Benton, Chisago, Isanti, Morrison, Sherburne, Stearns, Todd, Wright
- HealthPartners Minnesota Senior Health Options (HMO D-SNP) — Offered in MN: 12 counties
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
Highmark Blue Cross Blue Shield
2 plans on this site
- Highmark Health Options Duals (HMO D-SNP) — Offered in WV: 40 counties
- Highmark Health Options Duals Select (HMO D-SNP) — Offered in DE: Kent, New Castle, Sussex
Highmark Wholecare Medicare Assured
2 plans on this site
- Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) — Offered in PA: 57 counties
- Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) — Offered in PA: 57 counties
Independence Blue Cross
3 plans on this site
- Keystone 65 Preferred Rx (HMO) — Offered in PA: Chester, Delaware, Montgomery
- Keystone 65 Select Rx (HMO) — Offered in PA: Chester, Delaware, Montgomery
- Personal Choice 65 Rx (PPO) — Offered in PA: Chester, Delaware, Montgomery
Independent Health
3 plans on this site
- Independent Health's Encompass 65 RED 042 (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Encompass 65 RED 044 (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Independent Health's Medicare Passport Connect (PPO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
KelseyCare Advantage
2 plans on this site
- KelseyCare Advantage Freedom (HMO-POS) — Offered in TX: 13 counties
- KelseyCare Advantage Signature (HMO) — Offered in TX: Brazoria, Fort Bend, Galveston, Harris, Montgomery
L.A. Care Health Plan
1 plan on this site
- L.A. Care Medicare Plus (HMO D-SNP) — Offered in CA: Los Angeles
MyAdvocate Medicare Advantage
2 plans on this site
- MyAdvocate Medicare Advantage GOLD (HMO-POS) — Offered in NE: 21 counties
- MyAdvocate Medicare Advantage SILVER (HMO-POS) — Offered in NE: 21 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
Priority Health Medicare
12 plans on this site
- PriorityMedicare (HMO-POS) — Offered in MI: 18 counties
- PriorityMedicare Align (HMO-POS) — Offered in MI: 13 counties
- PriorityMedicare D-SNP (HMO D-SNP) — Offered in MI: 58 counties
- PriorityMedicare Dual Premier (HMO D-SNP) — Offered in MI: Berrien, Calhoun, Cass, Kalamazoo, Van Buren
- PriorityMedicare Edge (PPO) — Offered in MI: 13 counties
- PriorityMedicare Key (HMO-POS) — Offered in MI: 13 counties
- PriorityMedicare Latitude (HMO-POS) — Offered in MI: 19 counties
- PriorityMedicare Merit (PPO) — Offered in MI: 18 counties
- PriorityMedicare Smart Savings (HMO-POS) — Offered in MI: 18 counties
- PriorityMedicare Thrive (PPO) — Offered in MI: 13 counties
- PriorityMedicare Thrive Plus (PPO) — Offered in MI: 13 counties
- PriorityMedicare Value (HMO-POS) — Offered in MI: 18 counties
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
Samaritan Advantage Health Plans
1 plan on this site
- Samaritan Dual Advantage (HMO D-SNP) — Offered in OR: Benton, Lincoln, Linn
Security Health Plan of Wisconsin, Inc.
4 plans on this site
- Esteem Rx (HMO) — Offered in WI: 33 counties
- Esteem Rx Gold (HMO-POS) — Offered in WI: 33 counties
- Esteem Rx Silver (HMO-POS) — Offered in WI: 33 counties
- Legacy Rx (HMO-POS) — Offered in WI: 33 counties
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
South Country Health Alliance
2 plans on this site
- AbilityCare (HMO D-SNP) — Offered in MN: Brown, Dodge, Goodhue, Sibley, Steele, Wabasha, Waseca
- SeniorCare Complete (HMO D-SNP) — Offered in MN: Brown, Dodge, Goodhue, Sibley, Steele, Wabasha, Waseca
SummaCare Medicare Advantage Plans
5 plans on this site
- SummaCare Medicare Emerald (HMO-POS) — Offered in OH: 15 counties
- SummaCare Medicare Quartz (HMO) — Offered in OH: 25 counties
- SummaCare Medicare Ruby (HMO) — Offered in OH: 25 counties
- SummaCare Medicare Sapphire (HMO-POS) — Offered in OH: 31 counties
- SummaCare Medicare Topaz (HMO) — Offered in OH: 25 counties
Ultimate Health Plans
5 plans on this site
- Advantage Care COPD by Ultimate (HMO C-SNP) — Offered in FL: 12 counties
- Advantage Care by Ultimate (HMO C-SNP) — Offered in FL: Citrus, Hernando, Pasco
- Advantage Plus by Ultimate (Full) (HMO D-SNP) — Offered in FL: 16 counties
- Advantage Plus by Ultimate (Partial) (HMO D-SNP) — Offered in FL: 16 counties
- Premier by Ultimate (HMO) — Offered in FL: Citrus, Hernando, Indian River, Pasco, St. Lucie
VISTA Health Plan Inc.
2 plans on this site
- Amerihealth Caritas VIP Care (HMO D-SNP) — Offered in PA: 62 counties
- Keystone First VIP Choice (HMO D-SNP) — Offered in PA: Bucks, Chester, Delaware, Montgomery, Philadelphia
eternalHealth
6 plans on this site
- eternalHealth Catalina (HMO) — Offered in AZ: Pima
- eternalHealth Forever (HMO) — Offered in MA: Bristol, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- eternalHealth Freedom (PPO) — Offered in MA: Bristol, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- eternalHealth Give Back (PPO) — Offered in MA: Bristol, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
- eternalHealth Harmony (HMO) — Offered in AZ: Graham, Maricopa, Pinal
- eternalHealth Horizon (HMO) — Offered in AZ: Graham, Maricopa, Pima, Pinal
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