Dicyclomine Hydrochloride Medicare Coverage in Utah
cover Dicyclomine Hydrochloride
Medicare Plans Covering Dicyclomine Hydrochloride in Utah
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 Value Choice H5216-456 (PPO) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Total Complete H2486-003 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Molina Medicare Complete Care (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| HealthSpring Premier (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| HealthSpring True Choice (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC UT-0002 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Molina Medicare Complete Care Select (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Elite (PPO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE 001 UT (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Aetna Medicare Full Dual (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC UT-0005 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Select Health Medicare Essential (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Full Dual (PPO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE GIVEBACK 002 UT (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Aetna Medicare Signature (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| HumanaChoice SNP-DE H5216-296 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Complete Care UT-6 (HMO-POS C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Select Health Medicare Dual (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-428 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC UT-0008 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Value Choice H7617-032 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Extras UT-7 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Select Health Medicare Essential (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Signature Extra (PPO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Humana Essentials Plus Giveback H5216-430 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Giveback from UHC UT-9 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice SNP-DE H7617-038 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Dual Complete UT-V001 (PPO D-SNP) | $17.40/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Value Choice H5216-456 (PPO) | $20.30/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
Compare All Utah Plans for Dicyclomine Hydrochloride
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Frequently Asked Questions
100% of Medicare Part D plans in Utah cover Dicyclomine Hydrochloride. There are 30 plans available. Coverage and costs vary by specific plan.
The average 30-day copay for Dicyclomine Hydrochloride in Utah is $2.98 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.
Based on current CMS data, Humana Value Choice H5216-456 (PPO) offers one of the lowest copays for Dicyclomine Hydrochloride in Utah. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Dicyclomine Hydrochloride 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 Dicyclomine Hydrochloride
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