Lidocaine and Prilocaine Medicare Coverage in New Hampshire
cover Lidocaine and Prilocaine
Medicare Plans Covering Lidocaine and Prilocaine in New Hampshire
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 Giveback H7617-046 (PPO) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| WellSense Signature Access (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H5619-180 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H5216-138 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| WellSense Signature (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC NH-2 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Complete Care Support NH-2A (HMO-POS C-SNP) | $5.90/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| WellSense Choice (HMO) | $13.90/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Gold Plus H5619-137 (HMO) | $14.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Medicare Advantage NH-001A (PPO) | $21.70/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| WellSense Added Value (HMO) | $21.70/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC NH-0004 (PPO) | $39.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Nursing Home Plan EX-F003 (PPO I-SNP) | $42.40/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC NH-1 (HMO-POS) | $59.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC NH-0003 (PPO) | $70.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Aetna Medicare Elite (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | 0.2% | N/A | None | Details → |
Compare All New Hampshire Plans for Lidocaine and Prilocaine
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 New Hampshire cover Lidocaine and Prilocaine. There are 16 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 Giveback H7617-046 (PPO) offers one of the lowest copays for Lidocaine and Prilocaine in New Hampshire. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Lidocaine and Prilocaine 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 Lidocaine and Prilocaine
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