Leucovorin Calcium Medicare Coverage in Pennsylvania
cover Leucovorin Calcium
Medicare Plans Covering Leucovorin Calcium 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 |
|---|---|---|---|---|---|---|
| UPMC for Life Complete Care (HMO D-SNP) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H5525-085 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-037 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Special (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 015 PA (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE 007 PA (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 009 PA (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $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 → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Clover Health Choice (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-054 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Complete (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO 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 → |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| DEVOTED CHOICE GIVEBACK 008 PA (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Perennial Advantage Freedom (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Essentials from UHC PA-5 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| DEVOTED CORE 010 PA (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 → |
| DEVOTED CORE 023 PA (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 → |
| Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 Classic Essential Rx (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $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 010 PA (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Choice H8145-052 (PFFS) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Perennial Advantage Premier (HMO I-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
Compare All Pennsylvania Plans for Leucovorin Calcium
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover Leucovorin Calcium. 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, UPMC for Life Complete Care (HMO D-SNP) offers one of the lowest copays for Leucovorin Calcium in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Leucovorin Calcium 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 Leucovorin Calcium
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