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Medications

Perfluorohexyloctane eye drops (Miebo) — plans on this site that list it on Tier 4

1442 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

AlohaCare

1 plan on this site

AmeriHealth

2 plans on this site

AmeriHealth Caritas VIP Care (HMO-D-SNP)

1 plan on this site

Blue Care Network

4 plans on this site

Blue Cross Blue Shield of Arizona (AZ Blue)

3 plans on this site

Blue Cross Blue Shield of Michigan

8 plans on this site

Blue Cross Blue Shield of South Carolina

2 plans 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

CarePlus Health Plans, Inc.

17 plans on this site

Clover Health

8 plans on this site

Excellus Health Plan Community Care LLC

4 plans on this site

Excellus Health Plan, Inc

14 plans on this site

Fallon Health

3 plans on this site

First Choice VIP Care (HMO D-SNP)

1 plan on this site

Great Plains Medicare Advantage

3 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

Humana

486 plans on this site

Independence Blue Cross

8 plans on this site

Kaiser Permanente

110 plans on this site

KelseyCare Advantage

2 plans on this site

MyAdvocate Medicare Advantage

2 plans on this site

Peoples Health

11 plans on this site

Samaritan Advantage Health Plans

1 plan on this site

Security Health Plan of Wisconsin, Inc.

4 plans on this site

South Country Health Alliance

2 plans on this site

Tufts Health Plan

6 plans on this site

Ultimate Health Plans

5 plans on this site

UnitedHealthcare

696 plans on this site

VISTA Health Plan Inc.

2 plans on this site

WyoBlue Advantage

2 plans on this site

eternalHealth

6 plans on this site

iCare

1 plan 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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