Medications
Zaleplon (Sonata) — plans on this site that list it on Tier 4
181 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
Banner Medicare Advantage
1 plan on this site
- Banner Medicare Advantage Prime (HMO) — Offered in AZ: Maricopa
Blue Cross Blue Shield of Arizona (AZ Blue)
2 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 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 Louisiana
8 plans on this site
- Blue adVantage Classic (HMO-POS) — Offered in LA: 21 counties
- Blue adVantage Dual Plus (HMO-POS D-SNP) — Offered in LA: 64 counties
- Blue adVantage Giveback (HMO-POS) — Offered in LA: 31 counties
- Blue adVantage Liberty (PPO) — Offered in LA: 63 counties
- Blue adVantage Platinum (HMO-POS) — Offered in LA: 48 counties
- Blue adVantage Premier (PPO) — Offered in LA: 64 counties
- Blue adVantage Reliance (HMO-POS) — Offered in LA: 47 counties
- Blue adVantage Thrive (PPO) — Offered in LA: 31 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
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
Community Health Plan of WA Medicare Advantage
2 plans on this site
- Community Health Plan of WA Dual Complete (HMO D-SNP) — Offered in WA: 39 counties
- Community Health Plan of WA Dual Select (HMO D-SNP) — Offered in WA: 29 counties
Dean Advantage
4 plans on this site
- Dean Advantage Assurance (HMO-POS) — Offered in WI: Columbia, Dane, Dodge, Fond du Lac, Green, Iowa, Jefferson, Rock, Sauk
- Dean Advantage Balance (HMO-POS) — Offered in WI: Columbia, Dane, Dodge, Fond du Lac, Green, Iowa, Jefferson, Rock, Sauk
- Dean Advantage Complete (HMO) — Offered in WI: Columbia, Dane, Dodge, Fond du Lac, Green, Iowa, Jefferson, Rock, Sauk
- Dean Advantage Essential (HMO) — Offered in WI: Columbia, Dane, Dodge, Fond du Lac, Green, Iowa, Jefferson, Rock, Sauk
Essence Healthcare
7 plans on this site
- Essence Advantage (HMO) — Offered in IN: Clark, Crawford, Floyd, Harrison, Jefferson, Ripley, Scott, Switzerland, Washington; KY: 21 counties
- Essence Advantage Choice (PPO) — Offered in IN: Clark, Crawford, Floyd, Harrison, Jefferson, Ripley, Scott, Switzerland, Washington; KY: 21 counties
- Essence Advantage Choice Plus (PPO) — Offered in IL: Cook, DuPage, Will
- Essence Advantage Plus (HMO) — Offered in IL: Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, St. Clair, Washington; MO: 11 counties
- Essence Advantage Premier Plus (PPO) — Offered in IL: Bond, Clinton, Jersey, Macoupin, Madison, Monroe, St. Clair; MO: 11 counties
- Essence Advantage Prime (HMO) — Offered in MO: Chariton, Maries, Miller, Morgan, Osage, Randolph, Reynolds
- Essence Advantage Select (HMO) — Offered in IL: Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, St. Clair, Washington; MO: 13 counties
First Choice VIP Care (HMO D-SNP)
1 plan on this site
- First Choice VIP Care (HMO D-SNP) — Offered in SC: 46 counties
Geisinger Gold
9 plans on this site
- Geisinger Gold Classic 360 Rx (HMO) — Offered in PA: 19 counties
- Geisinger Gold Classic Advantage Rx (HMO) — Offered in PA: 21 counties
- Geisinger Gold Classic Complete Rx (HMO) — Offered in PA: 37 counties
- Geisinger Gold Classic Essential Rx (HMO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Advantage Rx (PPO) — Offered in PA: 29 counties
- Geisinger Gold Preferred Balance Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Preferred Complete Rx (PPO) — Offered in PA: 44 counties
- Geisinger Gold Secure Rx (HMO D-SNP) — Offered in PA: 63 counties
- Geisinger Gold Value Rx (HMO) — Offered in PA: 63 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
Group Health Cooperative of Eau Claire
2 plans on this site
- Cooperative Advantage (HMO D-SNP) — Offered in WI: 50 counties
- Cooperative Medicare Advantage (HMO) — Offered in WI: 50 counties
HAP CareSource MI Coordinated Health
1 plan on this site
- HAP CareSource MI Coordinated Health (HMO D-SNP) — Offered in MI: Macomb, Wayne
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
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
HealthSpring
15 plans on this site
- HealthSpring Achieve (HMO C-SNP) — Offered in MS: 12 counties
- HealthSpring Achieve Savings (HMO C-SNP) — Offered in AL: Chilton, Jefferson, Shelby, Talladega, Walker
- HealthSpring Alliance (HMO) — Offered in TX: 11 counties
- HealthSpring Preferred (HMO) — Offered in TN: 31 counties
- HealthSpring Preferred Extra Savings (HMO) — Offered in TX: 18 counties
- HealthSpring Preferred GA (HMO) — Offered in GA: 12 counties
- HealthSpring Preferred PA (HMO) — Offered in PA: Bucks, Chester, Delaware, Montgomery, Philadelphia
- HealthSpring Preferred Plus (HMO) — Offered in MS: 20 counties
- HealthSpring Preferred Savings (HMO) — Offered in KY: Boone, Campbell, Grant, Kenton, Pendleton; OH: 13 counties
- HealthSpring Premier (HMO-POS) — Offered in TN: 59 counties
- HealthSpring Primary (HMO) — Offered in TN: 25 counties
- HealthSpring TotalCare (HMO D-SNP) — Offered in AR: 43 counties
- HealthSpring TotalCare Plus (HMO D-SNP) — Offered in TN: 62 counties
- HealthSpring True Choice (PPO) — Offered in GA: Catoosa, Dade, Walker; MS: DeSoto, Marshall, Tate, Tunica; TN: 78 counties
- HealthSpring True Choice Savings (PPO) — Offered in IL: Cook, DuPage, Kane, Kankakee, Will
HealthTeam Advantage
4 plans on this site
- HealthTeam Advantage Plan I (PPO) — Offered in NC: 12 counties
- HealthTeam Advantage Plan II (PPO) — Offered in NC: 12 counties
- HealthTeam Advantage Thrive Plan (HMO) — Offered in NC: Alamance, Davidson, Davie, Forsyth, Guilford, Randolph, Rockingham
- HealthTeam Advantage Vitality Plan (PPO) — Offered in NC: 33 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
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
Medica
6 plans on this site
- Medica Advantage Dual (PPO D-SNP) — Offered in ND: 23 counties
- Medica Advantage Essential (PPO) — Offered in NE: 42 counties
- Medica Advantage Preferred (PPO) — Offered in SD: 15 counties
- Medica Advantage Select (PPO) — Offered in NE: 42 counties
- Medica Advantage Value (PPO) — Offered in MN: Anoka, Carver, Dakota, Ramsey, Scott, Washington
- Medica DUAL Solution (HMO D-SNP) — Offered in MN: 54 counties
Medical Mutual of Ohio
10 plans on this site
- MedMutual Advantage Choice (HMO) — Offered in OH: 19 counties
- MedMutual Advantage Classic (HMO-POS) — Offered in OH: 19 counties
- MedMutual Advantage Elite Enhanced (HMO-POS) — Offered in OH: Fulton, Lucas, Ottawa, Sandusky, Wood
- MedMutual Advantage Elite Preferred (PPO) — Offered in OH: Fulton, Lucas, Ottawa, Sandusky, Wood
- MedMutual Advantage Elite Prime (HMO-POS) — Offered in OH: Fulton, Lucas, Ottawa, Sandusky, Wood
- MedMutual Advantage Elite Standard (HMO-POS) — Offered in OH: Fulton, Lucas, Ottawa, Sandusky, Wood
- MedMutual Advantage Plus (HMO) — Offered in OH: 19 counties
- MedMutual Advantage Preferred (PPO) — Offered in OH: 24 counties
- MedMutual Advantage Premium (PPO) — Offered in OH: 24 counties
- MedMutual Advantage Select (PPO) — Offered in OH: 24 counties
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
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
Prominence Health Plan
11 plans on this site
- Prominence Beyond (HMO-POS) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Bridge (HMO D-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Diabetes and Heart (HMO C-SNP) — Offered in NV: Washoe
- Prominence Diabetes and Heart Care Plus (HMO C-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Diabetes and Heart Giveback (HMO C-SNP) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Dual (HMO D-SNP) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Extra Help (HMO) — Offered in TX: Brooks, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, Zapata
- Prominence Giveback (HMO) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Meridian (HMO-POS) — Offered in NV: Washoe
- Prominence Plus (HMO) — Offered in TX: Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter, Randall
- Prominence Silver Peak (HMO) — Offered in NV: Carson City, Churchill, Douglas, Lyon, Storey
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
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
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
The Health Plan
4 plans on this site
- The Health Plan SecureCare - Option II (HMO) — Offered in OH: 69 counties
- The Health Plan SecureCare SNP (HMO D-SNP) — Offered in WV: 55 counties
- The Health Plan SecureChoice Optimum (PPO) — Offered in OH: 77 counties
- The Health Plan SecureChoice Reliance (PPO) — Offered in WV: 55 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
Upper Peninsula Health Plan (UPHP) MI Coordinated Health
1 plan on this site
- Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) — Offered in MI: 15 counties
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