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Medications
Patiromer (Veltassa) — plans on this site that list it on Tier 4
128 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
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)
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 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
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
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
Excellus Health Plan, Inc
14 plans on this site
- Medicare Blue Choice 024 (HMO) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 025 (HMO-POS) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 026 (HMO-POS) — Offered in NY: Cayuga, Oneida, Onondaga, Oswego
- Medicare Blue Choice 028 (HMO) — Offered in NY: 13 counties
- Medicare Blue Choice 029 (HMO-POS) — Offered in NY: 13 counties
- Medicare Blue Choice 030 (HMO-POS) — Offered in NY: 13 counties
- Medicare Blue Choice 032 (HMO-POS) — Offered in NY: Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Montgomery, Otsego
- Medicare Blue Choice Core (HMO) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Medicare Blue Choice Optimum (HMO-POS) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Medicare Blue Choice Prime (HMO-POS) — Offered in NY: Livingston, Monroe, Ontario, Seneca, Wayne, Yates
- Univera SeniorChoice Advanced (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Basic (HMO) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Secure (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
- Univera SeniorChoice Value Plus (HMO-POS) — Offered in NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
Fallon Health
3 plans on this site
- Fallon Medicare Plus Blue (HMO) — Offered in MA: Bristol, Essex, Middlesex, Norfolk, Plymouth, Suffolk
- Fallon Medicare Plus Green (HMO) — Offered in MA: Bristol, Essex, Middlesex, Norfolk, Plymouth, Suffolk
- Fallon Medicare Plus Orange (HMO) — Offered in MA: Bristol, Essex, Middlesex, Norfolk, Plymouth, Suffolk
First Choice VIP Care (HMO D-SNP)
1 plan on this site
- First Choice VIP Care (HMO D-SNP) — Offered in SC: 46 counties
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
Health Alliance Plan by Henry Ford Health
12 plans on this site
- HAP Medicare Complete Assist (PPO D-SNP) — Offered in MI: 40 counties
- HAP Medicare Complete Duals (HMO D-SNP) — Offered in MI: 39 counties
- HAP Medicare Connect (HMO) — Offered in MI: 61 counties
- HAP Medicare Diabetes and Heart (HMO C-SNP) — Offered in MI: 61 counties
- HAP Medicare Explore (PPO) — Offered in MI: 60 counties
- HAP Medicare Prime (PPO) — Offered in MI: 60 counties
- HAP Medicare Superior (HMO) — Offered in MI: 61 counties
- HAP Member Assist (PPO) — Offered in MI: 60 counties
- HAP Senior Plus (HMO-POS) — Offered in MI: 61 counties
- HAP Senior Plus (PPO) — Offered in MI: 60 counties
- HAP Senior Plus Henry Ford Tiered Access (HMO) — Offered in MI: Genesee, Hillsdale, Jackson, Lapeer, Macomb, Oakland, Wayne
- Henry Ford Select (HMO) — Offered in MI: Genesee, Hillsdale, Jackson, Lapeer, Macomb, Oakland, Wayne
Health New England Medicare Advantage Plans
6 plans on this site
- Health New England Medicare Compass (PPO) — Offered in MA: Franklin, Hampden, Hampshire
- Health New England Medicare Plus (HMO) — Offered in MA: Berkshire, Franklin, Hampden, Hampshire
- Health New England Medicare Premium (HMO) — Offered in MA: Berkshire, Franklin, Hampden, Hampshire
- Health New England Medicare Select (HMO) — Offered in MA: Franklin, Hampden, Hampshire
- Health New England Medicare Standard (HMO) — Offered in MA: Berkshire
- Health New England Medicare Value (HMO) — Offered in MA: Franklin, Hampden, Hampshire
HealthSun Health Plans, Inc.
6 plans on this site
- HealthSun HealthAdvantage Plan (HMO) — Offered in FL: Miami-Dade
- HealthSun HealthAdvantage Plus (HMO) — Offered in FL: Miami-Dade
- HealthSun MediMax (HMO) — Offered in FL: Broward, Miami-Dade
- HealthSun MediSun Extra (HMO D-SNP) — Offered in FL: Broward, Miami-Dade, Palm Beach
- HealthSun MediSun Full Dual Extra (HMO D-SNP) — Offered in FL: Broward, Miami-Dade, Palm Beach
- HealthSun VitalCare (HMO C-SNP) — Offered in FL: Broward, Miami-Dade
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
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
Network Health Medicare Advantage Plans
7 plans on this site
- Network Health Anywhere (PPO) — Offered in WI: Kenosha, Milwaukee, Ozaukee, Racine, Washington, Waukesha
- Network Health Cares (PPO D-SNP) — Offered in WI: 24 counties
- Network Health Choice (PPO) — Offered in WI: 21 counties
- Network Health Go (PPO) — Offered in WI: Milwaukee, Ozaukee, Racine, Washington, Waukesha
- Network Health PlusRx (PPO) — Offered in WI: 21 counties
- Network Health PremierRx (PPO) — Offered in WI: 21 counties
- Network Health Select (PPO) — Offered in WI: 21 counties
Presbyterian Health Plan
1 plan on this site
- Presbyterian Dual Plus (HMO D-SNP) — Offered in NM: 20 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
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
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
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
Simply Healthcare Plans, Inc.
2 plans on this site
- Simply Complete Platinum (HMO D-SNP) — Offered in FL: 24 counties
- Simply Integrated Platinum (HMO D-SNP) — Offered in FL: 24 counties
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
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