Dalteparin Sodium Medicare Coverage in Pennsylvania
cover Dalteparin Sodium
Medicare Plans Covering Dalteparin Sodium 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 → |
| Aetna Medicare Advantra Dual Care (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 → |
| UPMC for Life Complete Care (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 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 Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $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 → |
| 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 Longevity (HMO I-SNP) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | $32.70/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | $32.70/mo | Tier 1 - Preferred Generic | $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 → |
| 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 → |
| Aetna Medicare Signature (PPO) | $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 → |
| Aetna Medicare Advantra Signature (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 → |
| Aetna Medicare PinnacleHealth Prime (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Chronic Care (HMO C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
Compare All Pennsylvania Plans for Dalteparin Sodium
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover Dalteparin Sodium. 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 Dalteparin Sodium in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Dalteparin Sodium 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 Dalteparin Sodium
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