Hydroxyzine Pamoate Medicare Coverage in Pennsylvania
cover Hydroxyzine Pamoate
Medicare Plans Covering Hydroxyzine Pamoate 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 |
|---|---|---|---|---|---|---|
| Jefferson Health Plans Complete (HMO) Lowest Copay | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Dual Complete PA-S002 (HMO-POS D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| HumanaChoice SNP-DE H7617-048 (PPO 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 → |
| HumanaChoice Giveback H5525-085 (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-035 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Giveback (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Geisinger Gold Secure Rx (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC PA-0002 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| Geisinger Gold Classic Essential Rx (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $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 Giveback H5525-085 (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-036 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Dual Complete PA-S3 (HMO-POS D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 Gold Plus H6622-037 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Select (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $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 → |
| AARP Medicare Advantage Essentials from UHC PA-5 (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| Humana Gold Choice H8145-052 (PFFS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC PA-0010 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| Humana Gold Plus H6622-054 (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| HumanaChoice H5525-051 (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Complete Care PA-17 (HMO-POS C-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
Compare All Pennsylvania Plans for Hydroxyzine Pamoate
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania 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, Jefferson Health Plans Complete (HMO) offers one of the lowest copays for Hydroxyzine Pamoate in Pennsylvania. 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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