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Hydroxyzine Pamoate Medicare Coverage in Utah

100%
of plans in Utah
cover Hydroxyzine Pamoate
38 of 38 plans
$2.14
Avg 30-day copay in Utah
30
Plans shown below

Medicare Plans Covering Hydroxyzine Pamoate 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 Total Complete H2486-003 (HMO) Lowest Copay $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Value Choice H7617-032 (PPO) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Aetna Medicare Full Dual (PPO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $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 →
HumanaChoice SNP-DE H5216-296 (PPO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice SNP-DE H7617-038 (PPO 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 →
HumanaChoice H5216-428 (PPO) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Select Health Medicare Essential (HMO) $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 →
Humana Essentials Plus Giveback H5216-430 (PPO) $0.00/mo Tier 3 - Preferred Brand $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 →
UHC Complete Care UT-6 (HMO-POS C-SNP) $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 H5216-456 (PPO) $0.00/mo Tier 3 - Preferred Brand $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 (HMO D-SNP) $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 →
AARP Medicare Advantage Giveback from UHC UT-9 (PPO) $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 3 - Preferred Brand $0.00 N/A None Details →
HumanaChoice H7617-016 (PPO) $25.30/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Dual Select H7617-039 (PPO D-SNP) $27.90/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
Humana Full Access H7617-025 (PPO) $29.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
UHC Nursing Home Plan UT-F001 (PPO I-SNP) $37.60/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
UHC Dual Complete UT-S001 (PPO D-SNP) $37.60/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
UHC Dual Complete UT-S2 (HMO-POS D-SNP) $37.60/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
AARP Medicare Advantage from UHC UT-0001 (PPO) $39.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
AARP Medicare Advantage from UHC UT-0003 (HMO-POS) $55.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
HumanaChoice H5216-048 (PPO) $69.30/mo Tier 3 - Preferred Brand $0.00 N/A None Details →

Compare All Utah Plans for Hydroxyzine Pamoate

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 Utah cover Hydroxyzine Pamoate. There are 30 plans available. Coverage and costs vary by specific plan.

The average 30-day copay for Hydroxyzine Pamoate in Utah is $2.14 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.

Based on current CMS data, Humana Total Complete H2486-003 (HMO) offers one of the lowest copays for Hydroxyzine Pamoate in Utah. Enter your ZIP code to see all plans and compare total annual costs including premiums.

Hydroxyzine Pamoate Coverage in Other States

Click any state to see the plans and costs available there.

Coverage data from CMS formulary files for plan year 2026. How we calculate costsNational coverage for Hydroxyzine Pamoate

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