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Home › Medications › Mometasone / formoterol inhaler (Dulera) › Tier 3 plans

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Medications

Mometasone / formoterol inhaler (Dulera) — plans on this site that list it on Tier 3

382 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.

AgeRight Advantage

3 plans on this site

Align Senior Care

3 plans on this site

Alignment Health Plan

72 plans on this site

Banner Medicare Advantage

1 plan on this site

Baylor Scott & White Health Plan

6 plans on this site

Blue Cross & Blue Shield of Rhode Island

5 plans on this site

Blue Cross and Blue Shield of Alabama

3 plans on this site

Blue Cross and Blue Shield of IL, NM

4 plans on this site

Blue Cross and Blue Shield of Kansas

3 plans on this site

Blue Cross and Blue Shield of Louisiana

8 plans on this site

Blue Cross and Blue Shield of Minnesota

3 plans on this site

Blue Cross and Blue Shield of Nebraska

3 plans on this site

Blue Plus

1 plan on this site

CDPHP Medicare Advantage

3 plans on this site

  • CDPHP $0 Medicare Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
  • CDPHP Choice Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
  • CDPHP Clear Rx (HMO) — Offered in NY: Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington

Capital Blue Cross

4 plans on this site

Capital Health Plan

4 plans on this site

Communicare Advantage

1 plan on this site

Community First

3 plans on this site

Community Health Choice

2 plans on this site

Community Health Plan of WA Medicare Advantage

2 plans on this site

CommunityCare Senior Health Plan (HMO)

4 plans on this site

Dean Advantage

4 plans on this site

El Paso Health Medicare Advantage

4 plans on this site

EmblemHealth

5 plans on this site

Essence Healthcare

7 plans on this site

Excellus Health Plan Community Care LLC

4 plans on this site

Excellus Health Plan, Inc

14 plans on this site

Florida Blue

2 plans on this site

Florida Blue HMO

6 plans on this site

Florida Complete Care

3 plans on this site

Geisinger Gold

9 plans on this site

Georgia Health Advantage

1 plan on this site

Gold Coast Health Plan

1 plan on this site

Group Health Cooperative of Eau Claire

2 plans on this site

HAP CareSource MI Coordinated Health

1 plan on this site

Health Alliance Plan by Henry Ford Health

12 plans on this site

HealthTeam Advantage

4 plans on this site

Healthy Arkansas, Inc.

3 plans on this site

Healthy Mississippi, Inc.

4 plans on this site

Highmark Blue Cross Blue Shield

2 plans on this site

Highmark Blue Cross Blue Shield or Highmark Blue Shield

20 plans on this site

Horizon Blue Cross Blue Shield of New Jersey

1 plan on this site

Jefferson Health Plans

10 plans on this site

KeyCare Advantage

2 plans on this site

L.A. Care Health Plan

1 plan on this site

Liberty Medicare Advantage

1 plan on this site

Lifeworks Advantage

1 plan on this site

Medica

6 plans on this site

Medical Mutual of Ohio

10 plans on this site

MultiCare Health Plan Medicare Advantage Evergreen Plans

2 plans on this site

NHC Advantage

1 plan on this site

Native Advantage

1 plan on this site

Network Health Medicare Advantage Plans

7 plans on this site

Peak Health

3 plans on this site

Perennial Advantage

4 plans on this site

Priority Health Medicare

12 plans on this site

ProCare Advantage

3 plans on this site

PruittHealth Premier

3 plans on this site

Regence BlueCross BlueShield of Oregon

3 plans on this site

Regence BlueShield

1 plan on this site

SCAN Health Plan

32 plans on this site

SECUR Health Plan

2 plans on this site

Sentara Medicare

2 plans on this site

Simpra Advantage

1 plan on this site

Solis Health Plans

5 plans on this site

St. Luke's Health Plan

3 plans on this site

The Health Plan

4 plans on this site

UPMC for Life

11 plans on this site

UPMC for Life Complete Care

1 plan on this site

Upper Peninsula Health Plan (UPHP) MI Coordinated Health

1 plan on this site

VillageHealth

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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