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Butalbital, Acetaminophen, and Caffeine Medicare Coverage in Indiana

100%
of plans in Indiana
cover Butalbital, Acetaminophen, and Caffeine
74 of 74 plans
30
Plans shown below

Medicare Plans Covering Butalbital, Acetaminophen, and Caffeine in Indiana

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
AARP Medicare Advantage from UHC IN-001P (PPO) Lowest Copay $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice H5216-188 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage from UHC IN-19 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Gold Plus H5619-053 (HMO-POS) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana USAA Honor Giveback with Rx (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage Essentials from UHC IN-10 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice Giveback H5216-322 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Anthem Full Dual Advantage (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Humana Full Access H5216-192 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage Giveback from UHC IN-20 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
UHC Dual Complete IN-S002 (PPO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Gold Plus SNP-DE H4939-003 (HMO-POS D-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice Giveback H5216-226 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
UHC Complete Care IN-21 (HMO-POS C-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Gold Plus H5619-071 (HMO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
HumanaChoice H5216-019 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice H5216-463 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Anthem I PathWays Dual Care Advantage (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
HumanaChoice H5216-229 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
UHC PathWays Dual Care IN-S1 (PPO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
MyTruAdvantage Choice Plus (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
AARP Medicare Advantage from UHC IN-13 (HMO-POS) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice H5525-008 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Provider Partners Indiana Community Plan (HMO I-SNP) $0.00/mo Tier 1 - Preferred Generic $0.00 N/A None Details →
HumanaChoice Giveback H7617-003 (PPO) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →

Compare All Indiana Plans for Butalbital, Acetaminophen, and Caffeine

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 Indiana cover Butalbital, Acetaminophen, and Caffeine. 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, AARP Medicare Advantage from UHC IN-001P (PPO) offers one of the lowest copays for Butalbital, Acetaminophen, and Caffeine in Indiana. Enter your ZIP code to see all plans and compare total annual costs including premiums.

View national coverage data for Butalbital, Acetaminophen, and Caffeine

Butalbital, Acetaminophen, and Caffeine Coverage in Other States

Click any state to see the plans and costs available there.

Alabama 100% — Arizona 100% — Arkansas 100% — California 100% — Colorado 100% — Connecticut 100% — Delaware 100% — District of Columbia 100% — Florida 100% avg $0.14/mo Georgia 100% — Hawaii 100% — Idaho 100% — Illinois 100% — Iowa 100% — Kansas 100% — Kentucky 100% — Louisiana 100% — Maine 100% — Maryland 100% avg $0.45/mo Massachusetts 100% avg $5.71/mo Michigan 100% avg $4.47/mo Minnesota 100% — Mississippi 100% — Missouri 100% avg $0.25/mo Montana 100% — Nebraska 100% — Nevada 100% — New Hampshire 100% — New Jersey 100% — New Mexico 100% — New York 100% — North Carolina 100% — North Dakota 100% — Ohio 100% avg $0.24/mo Oklahoma 100% — Oregon 100% avg $0.32/mo Pennsylvania 100% — Puerto Rico 100% — Rhode Island 100% — South Carolina 100% — South Dakota 100% — Tennessee 100% — Texas 100% — Utah 100% — Vermont 100% — Virginia 100% — Washington 100% avg $0.29/mo West Virginia 100% — Wisconsin 100% — Wyoming 100% —

Coverage data from CMS formulary files for plan year 2026. How we calculate costs • National coverage for Butalbital, Acetaminophen, and Caffeine

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