memantine hydrochloride and donepezil hydrochloride Medicare Coverage in Pennsylvania
cover memantine hydrochloride and donepezil hydrochloride
Medicare Plans Covering memantine hydrochloride and donepezil hydrochloride 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 |
|---|---|---|---|---|---|---|
| Jefferson Health Plans Complete (HMO) Lowest Copay | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Giveback (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | $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 → |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred 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 → |
| Jefferson Health Plans Select (HMO D-SNP) | $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 → |
| Aetna Community HealthChoices (HMO 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 → |
| Jefferson Health Plans Special (HMO 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 → |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | $13.10/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | $17.60/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex Pro (PPO) | $18.00/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 → |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex Plus (PPO) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Longevity (HMO I-SNP) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Prime (HMO) | $32.70/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare PinnacleHealth Prime (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Signature (PPO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature Plus (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Keystone 65 Basic Rx (HMO) | $0.00/mo | Tier 3 - Preferred Brand | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Prime Plus (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
Compare All Pennsylvania Plans for memantine hydrochloride and donepezil hydrochloride
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover memantine hydrochloride and donepezil hydrochloride. 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, Jefferson Health Plans Complete (HMO) offers one of the lowest copays for memantine hydrochloride and donepezil hydrochloride in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
memantine hydrochloride and donepezil hydrochloride 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 memantine hydrochloride and donepezil hydrochloride
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