dicyclomine hydrochloride Medicare Coverage in Pennsylvania
cover dicyclomine hydrochloride
Medicare Plans Covering dicyclomine hydrochloride 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 |
|---|---|---|---|---|---|---|
| Erickson Advantage Guardian (HMO-POS I-SNP) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Complete Blue PPO Signature (PPO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Geisinger Gold Secure Rx (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Distinct (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Keystone First VIP Choice (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| HumanaChoice H5525-051 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE GIVEBACK 011 PA (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Extras from UHC PA-18 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| DEVOTED CORE 012 PA (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Geisinger Gold Classic Essential Rx (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Complete Blue HMO Distinct (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| HumanaChoice SNP-DE H5216-227 (PPO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Select (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Complete Blue PPO Signature (PPO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Humana USAA Honor Giveback with Rx (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-035 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Community Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 2 - Generic | $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 → |
| Humana Gold Plus SNP-DE H5377-003 (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 013 PA (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Together Blue Medicare HMO Signature (HMO) | $0.00/mo | Tier 2 - 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 → |
| Perennial Advantage Freedom (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Complete Blue PPO Merit (PPO) | $0.00/mo | Tier 2 - 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 → |
| UPMC for Life Complete Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
Compare All Pennsylvania Plans for dicyclomine hydrochloride
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover dicyclomine hydrochloride. There are 30 plans available. Coverage and costs vary by specific plan.
The average 30-day copay for dicyclomine hydrochloride in Pennsylvania is $2.50 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.
Based on current CMS data, Erickson Advantage Guardian (HMO-POS I-SNP) offers one of the lowest copays for dicyclomine hydrochloride in Pennsylvania. 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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