Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide Medicare Coverage in Pennsylvania
cover Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide
Medicare Plans Covering Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide 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 |
|---|---|---|---|---|---|---|
| DEVOTED CHOICE GIVEBACK 011 PA (PPO) Lowest Copay | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Wellcare Dual Liberty Sync (HMO-POS D-SNP) | $0.00/mo | Tier 6 - Select Care | $0.00 | N/A | None | Details → |
| HealthSpring Achieve (HMO C-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Dual Care (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage from UHC PA-0002 (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| DEVOTED CORE 012 PA (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| UPMC for Life Complete Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| HumanaChoice Giveback H5525-085 (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| HealthSpring Preferred (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Signature (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-035 (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Special (HMO D-SNP) | $0.00/mo | Tier 6 - Select Care | $0.00 | N/A | None | Details → |
| Wellcare Simple (HMO-POS) | $0.00/mo | Tier 6 - Select Care | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Dual (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| DEVOTED GIVEBACK 013 PA (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Keystone 65 Focus Rx (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Chronic Care (HMO C-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| UPMC for Life Complete Care (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $0.00 | N/A | None | Details → |
| Personal Choice 65 Achieve Rx (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Clover Health Choice (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| HealthSpring Preferred (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Community HealthChoices (HMO D-SNP) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Signature Extra (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Flex (PPO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Humana Gold Plus H6622-036 (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Jefferson Health Plans Complete (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| HealthSpring Preferred PA (HMO) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
| AARP Medicare Advantage Essentials from UHC PA-5 (HMO-POS) | $0.00/mo | Tier 1 - Preferred Generic | $0.00 | N/A | None | Details → |
Compare All Pennsylvania Plans for Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide
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Frequently Asked Questions
100% of Medicare Part D plans in Pennsylvania cover Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide. 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, DEVOTED CHOICE GIVEBACK 011 PA (PPO) offers one of the lowest copays for Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide 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 Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide
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