Drug Coverage Check · Plan Year 2026
Does this plan cover
Hydroxyzine Pamoate?
Verified · CMS 2026
NOT Covered
Hydroxyzine Pamoate is not covered by DEVOTED CHOICE GIVEBACK 002 WA (PPO) in 2026.
See alternative plans below that do cover this medication, or ask your doctor about therapeutically similar alternatives that may be covered.
Plans That Cover Hydroxyzine Pamoate
These Medicare Part D plans cover Hydroxyzine Pamoate in 2026.
| # | Plan Name | Tier | 30-Day Copay | Monthly Premium | Rating | |
|---|---|---|---|---|---|---|
| 1 | Aetna Medicare Signature (HMO-POS) | Tier 4 | See Plan | $0.00/mo | — | View |
| 2 | Aetna Medicare Prime Extra (HMO-POS) | Tier 4 | See Plan | $0.00/mo | — | View |
| 3 | SCAN Balance (HMO C-SNP) | Tier 4 | See Plan | $0.00/mo | — | View |
| 4 | Aetna Medicare Elite (HMO-POS) | Tier 4 | See Plan | $0.00/mo | — | View |
| 5 | Aetna Medicare Signature (PPO) | Tier 4 | See Plan | $0.00/mo | — | View |
Therapeutically Similar Alternatives
Talk to your doctor about these therapeutically similar medications. They may be covered at a lower tier or with fewer restrictions.