Hydroxyzine Pamoate Medicare Coverage in Minnesota
cover Hydroxyzine Pamoate
Medicare Plans Covering Hydroxyzine Pamoate in Minnesota
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 |
|---|---|---|---|---|---|---|
| HumanaChoice H5216-275 (PPO) Lowest Copay | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Complete Care MN-7 (PPO C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC MN-0001 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Gundersen MN Quartz Med Advantage Basic D (w/Rx) (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AbilityCare (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| PrimeWest Senior Health Complete (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| SeniorCare Complete (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Prime Health Complete (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Gundersen MN Quartz Med Advantage Core D (w/Rx) (HMO) | $8.20/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-359 (PPO) | $10.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Choice H8145-006 (PFFS) | $10.80/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Complete Care Support MN-8 (PPO C-SNP) | $16.80/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Complete Care Support FG-5 (PPO C-SNP) | $19.90/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-092 (PPO) | $25.10/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC FG-0002 (PPO) | $38.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC FG-0001 (PPO) | $41.50/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Allina Health Aetna Medicare Value (PPO C-SNP) | $41.50/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC MN-0002 (PPO) | $54.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Gundersen MN Quartz Med Advantage Value D (w/Rx) (HMO) | $67.40/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-063 (PPO) | $90.10/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC MN-0005 (PPO) | $94.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC FG-0003 (PPO) | $95.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Gundersen MN Quartz Med Advantage Elite D (w/Rx) (HMO) | $184.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Allina Health Aetna Medicare Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Align ChoicePlus (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| Allina Health Aetna Medicare Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Allina Health Aetna Medicare Chronic (PPO C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Allina Health Aetna Medicare Signature Fit (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Allina Health Aetna Medicare Enhanced (PPO) | $28.30/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Align ChoiceElite (PPO) | $30.60/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
Compare All Minnesota Plans for Hydroxyzine Pamoate
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Frequently Asked Questions
100% of Medicare Part D plans in Minnesota cover Hydroxyzine Pamoate. 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, HumanaChoice H5216-275 (PPO) offers one of the lowest copays for Hydroxyzine Pamoate in Minnesota. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Hydroxyzine Pamoate 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 Hydroxyzine Pamoate
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