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oxycodone hydrochloride Medicare Coverage in Pennsylvania

100%
of plans in Pennsylvania
cover oxycodone hydrochloride
206 of 206 plans
30
Plans shown below

Medicare Plans Covering oxycodone 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
HumanaChoice SNP-DE H5216-227 (PPO D-SNP) Lowest Copay $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 Community HealthChoices (HMO D-SNP) $0.00/mo Tier 3 - Preferred Brand $0.00 N/A None Details →
AmeriHealth Caritas VIP Care (HMO D-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Humana USAA Honor Giveback with Rx (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Humana Gold Plus H6622-035 (HMO) $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 3 - Preferred Brand $0.00 N/A None Details →
Humana Gold Plus SNP-DE H5377-003 (HMO D-SNP) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
DEVOTED GIVEBACK 013 PA (HMO) $0.00/mo Tier 4 - Non-Preferred Drug $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 →
Wellcare Simple (HMO-POS) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
Geisinger Gold Preferred Complete Rx (PPO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Community HealthChoices (HMO D-SNP) $0.00/mo Tier 3 - Preferred Brand $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 4 - Non-Preferred Drug $0.00 N/A None Details →
Humana Gold Plus H6622-036 (HMO) $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 →
DEVOTED CORE 014 PA (HMO) $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 →
HumanaChoice SNP-DE H7617-048 (PPO 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 →
AARP Medicare Advantage from UHC PA-0002 (HMO-POS) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
DEVOTED CORE 008 PA (HMO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →
Aetna Community HealthChoices (HMO D-SNP) $0.00/mo Tier 3 - Preferred Brand $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 4 - Non-Preferred Drug $0.00 N/A None Details →
Humana Gold Plus H6622-037 (HMO) $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 →
Perennial Advantage Premier (HMO I-SNP) $0.00/mo Tier 2 - Generic $0.00 N/A None Details →
DEVOTED GIVEBACK 015 PA (HMO) $0.00/mo Tier 4 - Non-Preferred Drug $0.00 N/A None Details →

Compare All Pennsylvania Plans for oxycodone hydrochloride

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 Pennsylvania cover oxycodone 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, HumanaChoice SNP-DE H5216-227 (PPO D-SNP) offers one of the lowest copays for oxycodone hydrochloride in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.

oxycodone hydrochloride 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 oxycodone hydrochloride

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