Lidocaine and Prilocaine Medicare Coverage in Wisconsin
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Medicare Plans Covering Lidocaine and Prilocaine in Wisconsin
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 |
|---|---|---|---|---|---|---|
| AARP Medicare Advantage Essentials from UHC WI-13 (HMO-POS) Lowest Copay | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Humana Full Access H7617-020 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Community Care's Partnership Program (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-001 (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| UHC Complete Care WI-20 (HMO-POS C-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| UHC Complete Care WI-1 (PPO C-SNP) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC WI-0014 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| iCare Family Care Partnership (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aspirus Health Plan Essential Rx (PPO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Ally Rx (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| My Choice Wisconsin Partnership Plan (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Cooperative Advantage (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Esteem Rx (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Anthem Full Dual Advantage (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H5216-252 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| My Choice Wisconsin Partnership Plan (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC WI-0015 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Gundersen Quartz Med Advantage Basic D (w/Rx) (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Cooperative Medicare Advantage (HMO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| HumanaChoice H5216-253 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC WI-0017 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| UW Health Quartz Med Advantage Basic D (w/Rx) (HMO) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| HealthPartners Birch (PPO) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-SNP) | $0.00/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) | $0.00/mo | Tier 3 - Preferred Brand | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H7617-011 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Anthem Full Dual Advantage 2 (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Humana Full Access H5216-410 (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
Compare All Wisconsin Plans for Lidocaine and Prilocaine
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Frequently Asked Questions
100% of Medicare Part D plans in Wisconsin cover Lidocaine and Prilocaine. There are 30 plans available. Coverage and costs vary by specific plan.
The average 30-day copay for Lidocaine and Prilocaine in Wisconsin is $3.73 at a preferred pharmacy. Costs vary by plan. Compare plans to find the lowest cost option for you.
Based on current CMS data, AARP Medicare Advantage Essentials from UHC WI-13 (HMO-POS) offers one of the lowest copays for Lidocaine and Prilocaine in Wisconsin. 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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