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Lisdexamfetamine Dimesylate Medicare Coverage in Pennsylvania

100%
of plans in Pennsylvania
cover Lisdexamfetamine Dimesylate
89 of 89 plans
30
Plans shown below

Medicare Plans Covering Lisdexamfetamine Dimesylate 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
AARP Medicare Advantage Extras from UHC PA-18 (HMO-POS) Lowest Copay $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Clover Health Choice (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $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 →
UHC Dual Complete PA-S002 (HMO-POS D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
AARP Medicare Advantage from UHC PA-0011 (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $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 →
DEVOTED CHOICE GIVEBACK 003 PA (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
UHC Dual Complete PA-S001 (PPO 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 →
AARP Medicare Advantage from UHC PA-0002 (HMO-POS) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Medicare Advantra Dual (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
DEVOTED CORE 023 PA (HMO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
AARP Medicare Advantage from UHC PA-0015 (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $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 →
Aetna Community HealthChoices (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Erickson Advantage Guardian (HMO-POS I-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 →
AARP Medicare Advantage Essentials from UHC PA-5 (HMO-POS) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Perennial Advantage Freedom (HMO) $0.00/mo Tier 2 - Generic $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 →
UHC Complete Care PA-17 (HMO-POS C-SNP) $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 →
Aetna Community HealthChoices (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Erickson Advantage Liberty (HMO-POS) $14.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Medicare Chronic Care Value (HMO C-SNP) $28.80/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Medicare Chronic Care Value (HMO C-SNP) $29.70/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
UHC Dual Complete PA-V001 (HMO-POS D-SNP) $30.40/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
UHC Nursing Home Plan EX-F002 (PPO I-SNP) $32.60/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Medicare Chronic Care Value (HMO C-SNP) $32.70/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →

Compare All Pennsylvania Plans for Lisdexamfetamine Dimesylate

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Frequently Asked Questions

100% of Medicare Part D plans in Pennsylvania cover Lisdexamfetamine Dimesylate. 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, AARP Medicare Advantage Extras from UHC PA-18 (HMO-POS) offers one of the lowest copays for Lisdexamfetamine Dimesylate in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.

Lisdexamfetamine Dimesylate 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 Lisdexamfetamine Dimesylate

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