Diphenoxylate Hydrochloride and Atropine Sulfate Medicare Coverage in Wisconsin
cover Diphenoxylate Hydrochloride and Atropine Sulfate
Medicare Plans Covering Diphenoxylate Hydrochloride and Atropine Sulfate in Wisconsin
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 |
|---|---|---|---|---|---|---|
| HealthPartners Birch (PPO) Lowest Copay | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Anthem Full Dual Advantage (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| HealthPartners Cedar (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Community Care's Partnership Program (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Anthem Medicare Advantage (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Cooperative Advantage (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Anthem Medicare Advantage (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Cooperative Medicare Advantage (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Network Health Cares (PPO D-SNP) | $21.10/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Anthem Medicare Advantage 3 (PPO) | $41.70/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Medica Prime Solution Thrift w/Rx (Cost) | $43.80/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Medica Prime Solution Focus w/Rx (Cost) | $92.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Wellcare Dual Access Sync (HMO-POS D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $100.00 | N/A | None | Details → |
| Wellcare Dual Reserve (HMO-POS D-SNP) | $10.40/mo | Tier 4 - Non-Preferred Drug | $100.00 | N/A | None | Details → |
| Network Health Zero (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.4% | N/A | None | Details → |
| Aetna Medicare Signature (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 → |
| Network Health Select (PPO) | $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 → |
| Network Health Go (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Network Health Anywhere (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Network Health Choice (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 → |
| Aetna Medicare Premier (PPO) | $19.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Value Care (PPO) | $21.10/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Enhanced (PPO) | $24.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Network Health PlusRx (PPO) | $38.60/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Network Health PremierRx (PPO) | $92.80/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
Compare All Wisconsin Plans for Diphenoxylate Hydrochloride and Atropine 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 Wisconsin cover Diphenoxylate Hydrochloride and Atropine 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, HealthPartners Birch (PPO) offers one of the lowest copays for Diphenoxylate Hydrochloride and Atropine Sulfate in Wisconsin. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Diphenoxylate Hydrochloride and Atropine Sulfate 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 Diphenoxylate Hydrochloride and Atropine Sulfate
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