perphenazine and amitriptyline hydrochloride Medicare Coverage in Pennsylvania
cover perphenazine and amitriptyline hydrochloride
Medicare Plans Covering perphenazine and amitriptyline 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 |
|---|---|---|---|---|---|---|
| Aetna Community HealthChoices (HMO D-SNP) Lowest Copay | $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 Complete (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 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 Medicare Advantra Dual Care (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 Medicare Advantra Dual (HMO D-SNP) | $0.00/mo | Tier 4 - Non-Preferred Drug | $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 → |
| Jefferson Health Plans Prime (HMO) | $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 Chronic Care Value (HMO C-SNP) | $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 → |
| Security Blue HMO-POS Standard (HMO-POS) | $51.80/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Standard (HMO-POS) | $51.80/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Deluxe (HMO-POS) | $95.90/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Security Blue HMO-POS Deluxe (HMO-POS) | $95.90/mo | Tier 2 - Generic | $0.00 | N/A | None | Details → |
| Freedom Blue PPO Select (PPO) | $95.70/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| Freedom Blue PPO Standard (PPO) | $98.20/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| Freedom Blue PPO Select (PPO) | $115.70/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| Freedom Blue PPO Deluxe (PPO) | $122.40/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| Freedom Blue PPO Classic (PPO) | $140.90/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| Freedom Blue PPO Classic (PPO) | $145.40/mo | Tier 2 - Generic | $13.00 | N/A | None | Details → |
| HealthSpring Preferred (HMO) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.5% | N/A | None | Details → |
| Aetna Medicare Advantra Signature (PPO) | $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 Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
| Aetna Medicare Advantra Signature (HMO-POS) | $0.00/mo | Tier 4 - Non-Preferred Drug | 0.3% | N/A | None | Details → |
Compare All Pennsylvania Plans for perphenazine and amitriptyline 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 perphenazine and amitriptyline 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, Aetna Community HealthChoices (HMO D-SNP) offers one of the lowest copays for perphenazine and amitriptyline hydrochloride in Pennsylvania. Enter your ZIP code to see all plans and compare total annual costs including premiums.
perphenazine and amitriptyline 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 perphenazine and amitriptyline hydrochloride
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