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Drug Coverage Check · Plan Year 2026

Does this plan cover
Lisdexamfetamine Dimesylate?

Verified · CMS.gov Plan ID: H1395-001 Cross-check on Medicare.gov →
Verified · CMS 2026

YES — Covered

Lisdexamfetamine Dimesylate is covered on Tier 4

30-day copay: $100.00 at a preferred pharmacy

Cost Details

30-Day Supply

Preferred Pharmacy
$100.00
Standard Pharmacy
$100.00

90-Day / Mail Order

Preferred / Mail Order
$0.00
Standard Pharmacy
$0.00

Deductible

Applies to This Drug?
Yes — deductible applies before copay
Plan Deductible
$615.00 / year

Lower-Cost Plans for Lisdexamfetamine Dimesylate

These plans may offer a lower copay for Lisdexamfetamine Dimesylate. Compare total annual costs including premium.

# Plan Name Tier 30-Day Copay Monthly Premium Rating
1 Aetna Medicare Prime Extra (HMO) Tier 4 See Plan $0.00/mo View
2 Aetna Medicare Signature Extra (PPO) Tier 4 See Plan $0.00/mo View
3 Health First Emerald Plus H1099-028 (HMO) Tier 4 See Plan $0.00/mo View
4 Aetna Medicare Elite Care (PPO) Tier 4 See Plan $0.00/mo View
5 Wellcare Giveback (HMO-POS) 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.