acetohydroxamic acid Medicare Coverage in Pennsylvania
cover acetohydroxamic acid
Medicare Plans Covering acetohydroxamic acid in Pennsylvania
Sorted by lowest 30-day copay at a preferred pharmacy. Prices shown are estimates from CMS formulary data.
| Plan Name | Monthly Premium | Tier | 30-day Copay | Stars | Restrictions | Action |
|---|---|---|---|---|---|---|
| UPMC for Life Complete Care (HMO D-SNP) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UPMC for Life Complete Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UPMC for Life Complete Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Standard (HMO-POS) | $51.80/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Standard (HMO-POS) | $51.80/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Deluxe (HMO-POS) | $95.90/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Deluxe (HMO-POS) | $95.90/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Freedom Blue PPO Select (PPO) | $95.70/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| Freedom Blue PPO Standard (PPO) | $98.20/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| Freedom Blue PPO Select (PPO) | $115.70/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| Freedom Blue PPO Deluxe (PPO) | $122.40/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| Freedom Blue PPO Classic (PPO) | $140.90/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| Freedom Blue PPO Classic (PPO) | $145.40/mo | Tier 4 - Non-Preferred Drug | $95.00 | N/A | None | Details → |
| UPMC for Life HMO Premier Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life PPO Premier Rx (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life HMO Premier Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life PPO Essential Care Rx (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life PPO Premier Rx (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life HMO Premier Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life PPO Essential Care Rx (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life HMO Premier Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life HMO Premier Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $3.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $3.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $3.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $3.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $10.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $10.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Rx Choice (HMO) | $10.90/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| UPMC for Life HMO Deductible Rx (HMO) | $18.10/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
Compare All Pennsylvania Plans for acetohydroxamic acid
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover acetohydroxamic acid. There are 30 plans available. Coverage and costs vary by specific plan.
Costs vary by plan. Compare plans to find the lowest cost option for you.
Based on current CMS data, UPMC for Life Complete Care (HMO D-SNP) offers one of the lowest copays for acetohydroxamic acid in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
acetohydroxamic acid Coverage in Other States
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Coverage data from CMS formulary files for plan year 2026. How we calculate costs • National coverage for acetohydroxamic acid
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