Ampicillin and Sulbactam Medicare Coverage in Maine
cover Ampicillin and Sulbactam
Medicare Plans Covering Ampicillin and Sulbactam in Maine
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 |
|---|---|---|---|---|---|---|
| Humana Gold Plus SNP-DE H5619-003 (HMO D-SNP) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Wellcare Giveback (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| UHC Dual Complete ME-S1 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-175 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Gold Plus Giveback H5619-066 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Dual Complete ME-S2 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice SNP-DE H5216-291 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Full Dual (HMO-POS D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Dual Complete ME-S2 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Complete Care ME-6 (HMO-POS C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Partial Dual (HMO-POS D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC ME-0002 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Humana Gold Plus SNP-DE H5619-182 (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC ME-0002 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC ME-0005 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H7617-046 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Gold Plus H5619-001 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Dual Complete ME-S1 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Anthem I MaineHealth Advantage Dual Plus (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H5216-138 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Martin's Point Generations Advantage Select (PPO) | $8.40/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Wellcare Low Premium Open (PPO) | $9.70/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Humana Gold Plus H5619-137 (HMO) | $14.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Northern Light Health ME-0001 (HMO-POS) | $34.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Northern Light Health ME-0001 (HMO-POS) | $36.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Nursing Home Plan EX-F003 (PPO I-SNP) | $42.40/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC ME-0003 (PPO) | $84.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Martin's Point Generations Advantage Select (PPO) | $13.00/mo | Tier 2 - Generic | $5.00 | N/A | None | Details → |
Compare All Maine Plans for Ampicillin and Sulbactam
Enter your exact ZIP code to see plans available in your specific county, ranked by total annual cost.
Frequently Asked Questions
100% of Medicare Part D plans in Maine cover Ampicillin and Sulbactam. There are 30 plans available. Coverage and costs vary by specific plan.
The average 30-day copay for Ampicillin and Sulbactam in Maine is $0.82 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.
Based on current CMS data, Humana Gold Plus SNP-DE H5619-003 (HMO D-SNP) offers one of the lowest copays for Ampicillin and Sulbactam in Maine. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Ampicillin and Sulbactam 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 Ampicillin and Sulbactam
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