Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate Medicare Coverage in Pennsylvania
cover Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate
Medicare Plans Covering Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine 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 |
|---|---|---|---|---|---|---|
| Complete Blue PPO Signature (PPO) Lowest Copay | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Distinct (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $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 → |
| HumanaChoice Giveback H5525-085 (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-037 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Special (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Community Blue Medicare PPO Signature (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 015 PA (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Complete Blue HMO Distinct (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE 007 PA (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 009 PA (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Distinct (HMO) | $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 → |
| Complete Blue PPO Signature (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Complete Blue PPO Distinct (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Clover Health Choice (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-054 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Complete (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Community Blue Medicare PPO Signature (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Geisinger Gold Classic 360 Rx (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Complete Blue HMO Distinct (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $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 → |
| DEVOTED CHOICE GIVEBACK 008 PA (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
Compare All Pennsylvania Plans for Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate
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 Pennsylvania cover Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine 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, Complete Blue PPO Signature (PPO) offers one of the lowest copays for Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine 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 Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate
Get Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate Delivered to Your Door
Compare prices and get discounts from trusted online pharmacies
DrugCovered may earn commissions from pharmacy purchases. Prices and availability vary. Always consult your doctor before starting or changing medications.