Drug Coverage Check · Plan Year 2026
Does this plan cover
Ampicillin and Sulbactam?
Verified · CMS 2026
YES — Covered
Ampicillin and Sulbactam is covered on Tier 4
30-day copay: $75.00 at a preferred pharmacy
Cost Details
30-Day Supply
- Preferred Pharmacy
- $75.00
- Standard Pharmacy
- $100.00
90-Day / Mail Order
- Preferred / Mail Order
- $0.00
- Standard Pharmacy
- $75.00
Deductible
- Applies to This Drug?
- Yes — deductible applies before copay
- Plan Deductible
- $0.00 / year
Lower-Cost Plans for Ampicillin and Sulbactam
These plans may offer a lower copay for Ampicillin and Sulbactam. Compare total annual costs including premium.
| # | Plan Name | Tier | 30-Day Copay | Monthly Premium | Rating | |
|---|---|---|---|---|---|---|
| 1 | HealthSpring TotalCare (HMO D-SNP) | Tier 4 | See Plan | $0.00/mo | — | View |
| 2 | Medicare Plus Blue Secure (PPO) | Tier 4 | See Plan | $0.00/mo | — | View |
| 3 | HealthSpring Preferred (HMO) | Tier 4 | See Plan | $0.00/mo | — | View |
| 4 | HealthSpring Preferred Savings (HMO) | Tier 4 | See Plan | $0.00/mo | — | View |
| 5 | Blue Cross Medicare Advantage Basic (HMO) | 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.