codeine sulfate Medicare Coverage in Pennsylvania
cover codeine sulfate
Medicare Plans Covering codeine sulfate 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 |
|---|---|---|---|---|---|---|
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Lowest Copay | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Dual Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Dual (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | $13.10/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | $17.60/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | $28.80/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | $29.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Longevity (HMO I-SNP) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Capital Blue Cross Premier (HMO) | $25.30/mo | Tier 4 - Non-Preferred Drug | $100.00 | N/A | None | Details → |
| Capital Blue Cross Prime (PPO) | $77.30/mo | Tier 4 - Non-Preferred Drug | $100.00 | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Signature Giveback (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature Plus (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature Plus (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare PinnacleHealth Prime (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Prime Plus (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare PinnacleHealth Prime (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Signature Extra (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
Compare All Pennsylvania Plans for codeine sulfate
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover codeine sulfate. 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, Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) offers one of the lowest copays for codeine sulfate in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
codeine sulfate Coverage in Other States
Click any state to see the plans and costs available there.
Coverage data from CMS formulary files for plan year 2026. How we calculate costs • National coverage for codeine sulfate
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